Global cognition, executive function, and metacognition in a stroke population

Post-stroke cognitive impairment is associated with poor long-term outcomes and increased functional dependency. The overall study aim was to explore the relationships between global cognition, executive function and metacognition in a stroke population, to examine correlates and potential predictors of cognitive impairment and to determine the relationship between cognitive impairment and stroke in a Bahraini stroke sample in comparison to an age- and sex- matched control group. A sample of 130 stroke patients (case group) were recruited from the largest medical complex in Bahrain and 55 control participants from the non-stroke general population were recruited from two primary local health centres in the country. General demographic data, clinical assessment and neuropsychological battery of cognitive assessments was conducted on participants. The study found that individuals not affected by stroke have proportional risk factors to a stroke population in Bahrain. Approximately 48% of the stroke sample group had some degree of cognitive impairment with greater stroke severity being more significantly associated with worse overall cognitive impairment. Poorer performance on global cognition was correlated with executive dysfunction and more functional dependency. Stroke patients with higher levels of cognitive impairment were more likely to report lower cognitive self-consciousness levels, indicating an impairment in their metacognitive thought processes. Similarly, participants who performed poorly in the memory components of cognitive testing tended to subjectively report higher confidence in their memory skills, indicating an impairment in metamemory. Though no significant correlations were reported between total Metacognitive Questionnaire-30 scores and executive function and global cognition, the Metacognitive Questionnaire-30 was shown to be a good predictor of anxiety and depression post-stroke. The development of a tool that can consolidate both subjective and global objective assessment and thereby measure the full breadth of metacognitive function is necessary and may have important implications for future rehabilitation

25-Hydroxy Vitamin D, Adiponectin Levels and Cardiometabolic Risk Factors in a Sample of Obese Children

BACKGROUND: Association between vitamin D, adiponectin and obesity is a matter of debate, as they play important role in linking obesity with different cardio metabolic risk factors.AIM: Evaluation of association between metabolic risk factors with both adiponectin and 25-Hydroxy vitamin D [25(OH) D] levels and that between adiponectin and [25(OH) D] among obese Egyptian children.SUBJECTS AND METHODS: This case-control cross sectional study consisted of 65 obese and 30 healthy children, aged 8-11 years. 25(OH) D, serum adiponectin, total cholesterol, triglycerides, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol were measured.RESULTS: The mean 25(OH)D and adiponectin levels in the obese were lower than that in control group (ð‘ƒ<0.000). 25(OH)D were inversely correlated with body mass index, triglyceride, total cholesterol and LDL-cholesterol. While adiponectin level were inversely correlated with systolic and diastolic blood pressure, and positively correlated with high-density lipoprotein-cholesterol. However, there is no relation between 25(OH) D and adiponectin levels among obese children and total sample.CONCLUSION: Inspite of strong association between vitamin D and adiponectin levels with metabolic risk factors and obesity, there is no relation between 25(OH)D and adiponectin levels. In obese children, There are significant negative correlations between 25(OH)D with lipid profile, and between adiponectin levels with blood pressure

Fungicidal and nematicidal activities for essential oils formulated in Janus emulsion

<p>This study investigated the nematicidal and fungicidal activities of the two immiscible camphor and orange oils formulated in Janus emulsion (JE). JE was prepared from camphor and orange oils by a single-step emulsification with different concentrations chosen from an established phase diagram. Camphor oil nematicidal activity was studied against the root knot nematode <i>Meloidogyne incognita</i>, while orange oil fungicidal activity was studied against the wilt fungus <i>Fusarium oxysporum</i> f. sp. <i>lycopersici (Fol).</i> For a comparison study, different concentrations of JE and double emulsions were prepared. Results showed that JE had a significant mortality effect on the second-stage juveniles (J2s) <i>M. incognita</i> with 81% mortality and was able to delay the growth of <i>Fol</i> four and seven days after exposure, while changes in the efficiency of DE were recorded. Prepared JEs were shown to maintain the efficiency and to have slow release profiles for encapsulated oils.</p

Utility of Intracranial Vessel Wall MRI as a Diagnostic Tool for Primary CNS Vasculitis: Protocol for a Systematic Review

This study will describe the available evidence for use vessel wall MRI in the diagnosis of Primary CNS Vasculitis. A better understanding of the effectiveness of vessel wall MRI as an alternative to more invasive diagnostic testing will be helpful in the development of future diagnostic guidelines for Primary CNS Vasculitis

Metacognitive function poststroke: a review of definition and assessment.

Metacognition is the conscious knowledge individuals have about their own cognitive capacities and the regulation of these activities through self-monitoring. The aim of this review was to identify the definitions and assessment tools used to examine metacognition in relation to stroke studies. A computer database search was conducted using MEDLINE, CINAHL, PsycINFO, Cochrane Reviews, Scopus and Web of Science. A total of 1412 publications were retrieved from the initial database search. Following the removal of unrelated articles, 34 articles remained eligible. 5 studies examined metacognition in relation to cognitive and/or emotional functioning, 4 examined the concept in relation to memory, while others investigated its relationship to driving, employment or restrictions in daily living. 12 studies examined metacognitive function exclusively in stroke. Only 1 study examined metacognition in the acute phase of stroke. 7 studies adhered to the standard definition of metacognition in line with the neuropsychological literature. The main assessment tools utilised included the Self-Regulation and Skills Interview (SRSI), the Self-Awareness of Deficits Interview (SADI), the Awareness Questionnaire (AQ) and the Patient Competency Rating Scale (PCRS). Assessment of metacognition has tended to focus on traumatic and other acquired brain injury in comparison to stroke. The majority of the studies that examined metacognition in stroke did not assess patients in the acute phase. The heterogeneity of assessment tools was in keeping with the variation in the definition of metacognition. The emergence of a standard metacognitive assessment tool may have important implications for future rehabilitative programmes.</p

Une économie en transition

Après avoir connu une croissance réelle du produit intérieur brut de 9 % par an entre 1974 et 1984, due à des facteurs essentiellement externes, l’économie égyptienne a stagné pendant des années en dépit d’une aide extérieure massive, ce qui a conduit à une crise financière ayant nécessité la mise en œuvre, à partir de 1991, d’un programme de stabilisation économique et d’ajustement structurel. Ce programme de restructuration d’ensemble et de libéralisation globale, et non partielle comme lors de l’infitah sadatienne, a pour enjeu la transition d’une économie rentière dirigiste à une économie de production internationalisée. […

Self-Reported Severity and Causes of Traumatic Brain Injury in Patients With Epileptic or Functional Seizures

Background and objectivesAlthough moderate and severe traumatic brain injury (TBI) can cause posttraumatic epilepsy (PTE), many patients with functional seizures (FS) also report a history of mild TBI. To determine whether features of TBI history differ between patients with epileptic seizures (ES) and FS, we compared patient reports of TBI severity, symptoms, and causes of injury.MethodsWe recruited patients undergoing video-EEG evaluation for the diagnosis of ES, FS, mixed ES and FS, or physiologic seizure-like events at an academic, tertiary referral center. Patients and their caregivers were interviewed before final video-EEG diagnosis regarding their TBI histories, including concussive symptoms and causes of injury.ResultsOf 506 patients, a greater percentage of patients with FS reported a history of TBI than patients with ES (70% vs 59%, aOR = 1.75 [95% CI: 1.00-3.05], p = 0.047). TBI with loss of consciousness (LOC) lasting less than 30 minutes was more frequently reported among patients with FS than with ES (27% vs 13%, aOR = 2.38 [1.26-4.47], p &lt; 0.01). The proportion of patients reporting other neurologic symptoms immediately after TBI was not significantly different between FS and ES (40% vs 29%, p = 0.08). Causes of TBI were found to differ, with TBIs caused by falls from a height (17% vs 10%, aOR = 2.24 [1.06-4.70], p = 0.03) or motor vehicle collisions (27% vs 11%, aOR = 2.96 [1.54-5.67], p &lt; 0.01) reported more frequently in FS than ES.DiscussionOur findings further the association of mild TBI with FS and prompt reconsideration of typical assumptions regarding the significance of a reported TBI history in patients with previously undifferentiated seizures. Although common in both groups, TBI with LOC less than 30 minutes and causes of injury that are commonly believed to be more severe were reported more frequently in FS than ES. This suggests that a patient or caregiver reporting of these features does not imply that PTE is a more probable diagnosis than FS. Although a history of TBI with LOC and presumed high-risk causes of injury intuitively raises suspicion for PTE, clinicians should be cautioned that these historical factors also were a frequent finding in patients with FS

Reliability of additional reported seizure manifestations to identify dissociative seizures.

PurposeDescriptions of seizure manifestations (SM), or semiology, can help localize the symptomatogenic zone and subsequently included brain regions involved in epileptic seizures, as well as identify patients with dissociative seizures (DS). Patients and witnesses are not trained observers, so these descriptions may vary from expert review of seizure video recordings of seizures. To better understand how reported factors can help identify patients with DS or epileptic seizures (ES), we evaluated the associations between more than 30 SMs and diagnosis using standardized interviews.MethodsBased on patient- and observer-reported data from 490 patients with diagnoses documented by video-electoencephalography, we compared the rate of each SM in five mutually exclusive groups: epileptic seizures (ES), DS, physiologic seizure-like events (PSLE), mixed DS and ES, and inconclusive testing.ResultsIn addition to SMs that we described in a prior manuscript, the following were associated with DS: light triggers, emotional stress trigger, pre-ictal and post-ictal headache, post-ictal muscle soreness, and ictal sensory symptoms. The following were associated with ES: triggered by missing medication, aura of déjà vu, and leftward eye deviation. There were numerous manifestations separately associated with mixed ES and DS.ConclusionsReported SM can help identify patients with DS, but no manifestation is pathognomonic for either ES or DS. Patients with mixed ES and DS reported factors divergent from both ES-alone and DS-alone