Usefulness of a brief informant interview to detect dementia, translated into Spanish (AD8-Ch)

Cartas al Edito

A systematic review and meta-analysis of the diagnostic accuracy of the Phototest for cognitive impairment and dementia

The recently developed Phototest is a simple, easy and very brief test for detecting cognitive impairment or dementia. Objective: To evaluate the diagnostic accuracy of the Phototest for detecting cognitive impairment or dementia. METHODS: We used a manually created database to search for studies evaluating the Phototest diagnostic yield and performed an initial meta-analysis to determine sensitivity (Sn) and specificity (Sp) of diagnostic parameters. We also performed a second meta-analysis of individual participant data. RESULTS: In total, 6 studies were included in the meta-analysis. For dementia, Sn was 0.85 (95% CI, 0.82-0.88) and Sp 0.87 (95% CI, 0.85-0.99); for cognitive impairment, Sn was 0.80 (95% CI, 0.77-0.92) and Sp 0.88 (95% CI, 0.86-0.90). In the individual data meta-analysis, 1565 subjects were included, where best cut-off points for dementia and for cognitive impairment were 26/27 (Sn=0.89 (95% CI 0.85-0.91), Sp=0.84 (95% CI, 0.82-0.91)) and 28/29 (Sn=0.79 (95% CI, 0.76-0.81), Sp=0.88 (95% CI, 0.86-0.90)), respectively. CONCLUSION: Phototest has good diagnostic accuracy for dementia and cognitive impairment. It is brief, simple and can be used in illiterate persons. This makes it suitable for use in primary care settings and/or in subjects with low educational level.Phototest é um teste simples, fácil e muito rápido para detecção de comprometimento cognitivo e demência recentemente desenvolvido. Objetivo: Avaliar a acurácia diagnostica do Phototest para detecção de comprometimento cognitivo e demência. MÉTODOS: Nós usamos um banco de dados manualmente criado para estudos que avaliassem a capacidade diagnóstica do Phototest e realizamos uma meta-análise para determinar a sensibilidade (Sn) e especificidade (Ep) dos parâmetros diagnósticos. Nós também realizamos uma segunda meta-análise dos dados individuais dos participantes. RESULTADOS: Um total de seis estudos foram incluídos na meta-análise. Para demência a Sn foi 0.85 (95% CI, 0,82-0,88) e Ep 0,87 (95% CI, 0,85-0,99); para comprometimento cognitivo a Sn foi 0,80 (95% CI, 0,77-0,92) e Sp 0,88 (95% CI, 0,86-0,90). Na meta-análise de dados individuais, 1565 foram incluídos, os melhores escores de corte para demência e para comprometimento cognitivo foram 26/27 (Sn=0,89 (95% CI 0,85-0,91), Ep=0,84 (95% CI, 0,82-0,91)) e 28/29 (Sn=0,79 (95% CI, 0,76-0,81), Ep=0,88 (95% CI, 0,86-0,90)), respectivamente. CONCLUSÃO: Photest tem boa acurácia diagnostica para demência e comprometimento cognitivo. É breve, simples e pode ser usado em pessoas analfabetas. Tornando-o apropriado para o uso em cuidados primários e/ou sujeitos com baixo nível educacional.Fil: Carnero Pardo, Cristobal. Hospital Universitario Virgen de Las Nieves; España. Fidyan Neurocenter; EspañaFil: Lopez Alcalde Samuel. Fidyan Neurocenter; España. Hospital Universitario Virgen de Las Nieves; EspañaFil: Allegri, Ricardo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas ; ArgentinaFil: Russo, María Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas ; Argentin

Proximity effect in normal metal-multiband superconductor hybrid structures

A theory of the proximity effect in normal metal¿multiband superconductor hybrid structures is formulated within the quasiclassical Green's function formalism. The quasiclassical boundary conditions for multiband hybrid structures are derived in the dirty limit. It is shown that the existence of multiple superconducting bands manifests itself as the occurrence of additional peaks in the density of states in the structure. The interplay between the proximity effect and the interband coupling influences the magnitudes of the gaps in a superconductor in a nontrivial way and can even give rise to an enhancement of multiband superconductivity by the proximity to a superconductor with a lower transition temperature. The developed theory is applied to the calculation of supercurrent in multiband superconductor¿normal metal¿superconductor Josephson junctions with low-transparent interfaces, and the results are compared with the predictions for multiband tunnel junctions

Structural analysis of the adenovirus type 2 E3/19K protein using mutagenesis and a panel of conformation-sensitive monoclonal antibodies

The E3/19K protein of human adenovirus type 2 (Ad2) was the first viral protein shown to interfere with antigen presentation. This 25 kDa transmembrane glycoprotein binds to major histocompatibility complex (MHC) class I molecules in the endoplasmic reticulum (ER), thereby preventing transport of newly synthesized peptide–MHC complexes to the cell surface and consequently T cell recognition. Recent data suggest that E3/19K also sequesters MHC class I like ligands intracellularly to suppress natural killer (NK) cell recognition. While the mechanism of ER retention is well understood, the structure of E3/19K remains elusive. To further dissect the structural and antigenic topography of E3/19K we carried out site-directed mutagenesis and raised monoclonal antibodies (mAbs) against a recombinant version of Ad2 E3/19K comprising the lumenal domain followed by a C-terminal histidine tag. Using peptide scanning, the epitopes of three mAbs were mapped to different regions of the lumenal domain, comprising amino acids 3–13, 15–21 and 41–45, respectively. Interestingly, mAb 3F4 reacted only weakly with wild-type E3/19K, but showed drastically increased binding to mutant E3/19K molecules, e.g. those with disrupted disulfide bonds, suggesting that 3F4 can sense unfolding of the protein. MAb 10A2 binds to an epitope apparently buried within E3/19K while that of 3A9 is exposed. Secondary structure prediction suggests that the lumenal domain contains six β-strands and an α-helix adjacent to the transmembrane domain. Interestingly, all mAbs bind to non-structured loops. Using a large panel of E3/19K mutants the structural alterations of the mutations were determined. With this knowledge the panel of mAbs will be valuable tools to further dissect structure/function relationships of E3/19K regarding down regulation of MHC class I and MHC class I like molecules and its effect on both T cell and NK cell recognition

Computing Permutation Encodings

We consider some encodings of permutations of the first N natural numbers, discuss some relations among them and how one can be computed from others. We show a short proof of an existing efficient algorithm for one encoding, and present two new efficient algorithms for encoding permutations. One of these algorithms is constructed as the inverse of an existing algorithm for decoding, making it the first efficient permutation encoding algorithm obtained that way

Les intermédiaires privés dans les finances royales espagnoles sous Philippe V et Ferdinand VI

Paper played by private interests in XVIIIth century Spanish Exchequer: private compagnies as a tool for the reform of public finances; private intermediation in the royal finances after the reforms of the first half of the XVIIIth century; embeddedness of the management of State securities withing non-financial social networksRôle du privé dans les finances royales espagnoles: place des compagnies financières dans la réforme de l'appareil financier d'Etat de la première moitié du XVIIIe siècle; place de l'intermédiation privée dans le fonctionnement de ce même appareil après la réformes; insertion du maniement des titres de créances sur l'Etat dans le jeu des relations sociale

An Approach of Initiating Geriatric Screening OPD at the Rural Health Training Centre of SMVMCH, Pondicherry

Objectives: To study the common chronic health problems among the elderly patients attending in recently initiated geriatric screening OPD at the RHTC. Material and Methods: Since one year, screening OPD has been started at RHTC of SMVMCH, for old patients (>60 years), twice a week. A team of trained medical interns, a post-graduate, a faculty in Community Medicine and a counselor screen and counsel the elderly patients for common medical and mental health problems. The screening tool is structured and has been adopted for patients of geriatric OPD at RHTC. The screening tool consist of General Health Questionnaire (GHQ-5), Psychosis screening, Alzheimer’s disease (AD8) questionnaire and checklist of common medical conditions. Patients were screened for early detection of health problems followed by counseling them/their caregivers and referral to specialty OPD for further care. Results: Total 512 elderly patients were screened over 4 months period from the start of geriatric OPD. Out of them, 276 (54%) and 117 (23%) were between the age group of 60-65 years and 66-70 years respectively. Among them 387 (75%) were below poverty line and 68 (13.3%) were having some kind of health insurance. GHQ score indicates that 255 (50%) patients had a score more than one and it was significantly higher among females compared to males. About 76 (16.8%) elderly had a score of > 1 for psychosis, out of which only 12 (14%) were referred to the higher centre. AD8 score shows 204 (40%) patients attended the clinic having a score more than 1 and it is significantly higher among females compared to males. Counseling for caregivers was given only in 13 (6%) of the patients with high AD8 score. Common chronic conditions present among them were joint pains (310, 60%), visual disturbances (247, 48%), hearing difficulty (120, 23.4%) and hypertension (107, 21%). Conclusion: The proportion of people with AD8 score more than 1 is high and most common chronic condition seen is joint pain. The action component of the clinic such as referral of dementia patients, psychosis patients and counseling of their care-givers need to be strengthened