Neuropsychological Test Performance in African-American and White Patients with Alzheimer's Disease

Little information exists on the performance of black versus white patients with Alzheimer's disease on neuropsychological tests for dementia.In this study, we compared performance on the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) neuropsychological battery between white (n equals 830) and black (n equals 158) patients with Alzheimer's disease enrolled in the CERAD study at 23 university medical centers in the United States. The black patients were older, had fewer years of formal education, and were more impaired in their activities of daily living than were the white patients. After controlling for these characteristics and for duration of the disease and severity of dementia, there were differences in the performance of black and white patients on several of the cognitive measures. Black patients scored lower than whites on tests of visual naming and constructional praxis and on the Mini-Mental State Examination. There were no statistical differences in performance on tests of fluency and word list memory. These findings suggest that cultural or experiential differences may modify performance on specific neuropsychological tests. These factors, in addition to age and educational background, should be considered when interpreting performance on neuropsychological tests in elderly black patients with dementia

Тактика ведения пациентов при синдроме Мэллори-Вейсса

МЭЛЛОРИ-ВЕЙСА СИНДРОМ /диагн /терПИЩЕВОДА ПЕРФОРАЦИЯ /диагн /терЖЕЛУДОЧНО-КИШЕЧНОЕ КРОВОТЕЧЕНИЕГЕМОСТАЗ ЭНДОСКОПИЧЕСКИ

The Effect of Smoking on Long-term Gray Matter Atrophy and Clinical Disability in Patients with Relapsing-Remitting Multiple Sclerosis

The relationship between smoking, long-term brain atrophy, and clinical disability in patients with multiple sclerosis (MS) is unclear. Here, we assessed long-term effects of smoking by evaluating MRI and clinical outcome measures after 10 years in smoking and nonsmoking patients with relapsing-remitting MS (RRMS).publishedVersio

Serum neurofilament as a predictor of 10-year grey matter atrophy and clinical disability in multiple sclerosis: a longitudinal study

Background The predictive value of serum neurofilament light chain (sNfL) on long-term prognosis in multiple sclerosis (MS) is still unclear. Objective Investigate the relation between sNfL levels over a 2-year period in patients with relapsing-remitting MS, and clinical disability and grey matter (GM) atrophy after 10 years. Methods 85 patients, originally enrolled in a multicentre, randomised trial of ω−3 fatty acids, participated in a 10-year follow-up visit. sNfL levels were measured by Simoa quarterly until month 12, and then at month 24. The appearance of new gadolinium-enhancing (Gd+) lesions was assessed monthly between baseline and month 9, and then at months 12 and 24. At the 10-year follow-up visit, brain atrophy measures were obtained using FreeSurfer. Results Higher mean sNfL levels during early periods of active inflammation (Gd+ lesions present or recently present) predicted lower total (β=−0.399, p=0.040) and deep (β=−0.556, p=0.010) GM volume, lower mean cortical thickness (β=−0.581, p=0.010) and higher T2 lesion count (β=0.498, p=0.018). Of the clinical outcomes, higher inflammatory sNfL levels were associated with higher disability measured by the dominant hand Nine-Hole Peg Test (β=0.593, p=0.004). Mean sNfL levels during periods of remission (no Gd+ lesions present or recently present) did not predict GM atrophy or disability progression. Conclusion Higher sNfL levels during periods of active inflammation predicted more GM atrophy and specific aspects of clinical disability 10 years later. The findings suggest that subsequent long-term GM atrophy is mainly due to neuroaxonal degradation within new lesions.publishedVersio

Kriger og kjæreste - faktorer før, under og etter utenlandsoppdrag som kan påvirke samliv

Between 1200 and 1600 Norwegian military personnel annually participate in international operations. Their participation can be experienced as a strain on both the soldiers and their families, yet it is also a situation about mastering skills and personal growth. Two studies carried out by the Work Research Institute show a clear relationship between the break-up of cohabitations and the number of foreign postings among Norwegian servicemen. There is uncertainty about what contributes to the relationship between service abroad and the break-up of cohabitations. This thesis explores factors before, during and after service abroad that can influence soldiers’ cohabitations. We use attachment theory to discuss the effects of service abroad on the relationship between the soldier and those at home, and on the individual serviceman. Knowledge about how service abroad affects cohabitation can provide a foundation for developing preventive and intervening measures. The Norwegian military has a current proclaimed policy of increased focus on the family and measures aimed at military families. This thesis presents a small selection of these measures

Effects Of Military Service On Marital Stability Among World War Ii U.S. Veterans Of Japanese Descent

INTRODUCTION: This study had two goals. First, we investigated how World War II (WW II) military service impacted marital stability during men\u27s young and middle adulthood in a large community sample of American men of Japanese descent. Second, within a subgroup of WW II veterans, we assessed how the level of combat exposure affected marital stability. MATERIAL AND METHODS: The Honolulu Heart Program and later Honolulu-Asia Aging Project were longitudinal, community-based studies of Japanese-American men living in Hawai\u27i. This study is a secondary data analysis of 1,249 male WW II veterans and 3,489 men of Japanese descent who were civilians during WW II, born 1910-1919, who completed interviews at the first (1965-1968) and third (1971-1975) exams. Data from a subsample of veterans who completed a military service interview during the sixth exam (1997-1999) also were used. In the first set of analyses, we compared veterans to civilians on three marital outcomes for ages 15-59: (1) likelihood of never marrying, (2) age at first marriage, and (3) likelihood of divorce. Next, we investigated the negative consequences of increasing combat exposure on the same marital outcomes. All analyses controlled for age in 1941 and occupation. RESULTS: Overall, 88% of the sample remained in their first marriage with no differences between veterans and civilians. We found no effects of military service on the timing of first marriages on the likelihood of divorce during young and middle adulthood. However, among those who had not married before WW II, veterans were significantly more likely to remain unmarried compared with civilians; odds ratio = 1.52 (1.10, 2.09). The level of combat exposure did not predict any of the three marital outcomes among WW II veterans. In fact, none of the other military service characteristics assessed (i.e., age of military induction, years of service, and service-connected disability) predicted marital outcomes. We found that age at the beginning of WW II impacted the timing and stability of marriage in both veterans and civilians. Finally, we identified cultural effects on the likelihood of marriage between Nisei and Kibei groups with Nisei men being less likely to marry. CONCLUSION: Similar to other groups in this era, long-term marriage with one partner was the norm for both veterans and civilians. For a small portion of American men of Japanese descent, military service seemed to impact the transition into marriage. However, we found no differences in the timing of marriage or the likelihood of divorce based on military service or level of combat exposure. While our findings are inconsistent with previous research on the impact of military service and combat exposure, much of that research was conducted with mainland veterans, usually of European descent. There appears to be little long-term disruption of life course events. Results highlight the importance of studying diverse groups of veterans to understand how experiences in the military interact with pre-military factors in defining long-term responses to military service

Long-term consumption of an obesogenic high fat diet prior to ischemia-reperfusion mediates cardioprotection via Epac1-dependent signaling

Background: Obesity is still considered a risk factor for cardiovascular disease, although more recent knowledge also suggests obesity to be associated with reduced morbidity and mortality - the “obesity paradox”. This study explores if long-term feeding of an obesogenic high fat diet renders the myocardium less susceptible to ischemic-reperfusion induced injury via Epac-dependent signaling. Methods: Wild type (wt), Epac1 (Epac1−/− ) and Epac2 (Epac2−/− ) deficient mice were fed a high fat (HFD) or normal chow diet (ND) for 33 ± 1 weeks. Six experimental groups were included: (1) control wt ND (wt ND), (2) control wt HFD (wt HFD), (3) Epac1−/− mice on ND (Epac1−/− ND), (4) Epac1−/− mice on HFD (Epac1−/− HFD), (5) Epac2−/− mice on ND (Epac2−/− ND), and (6) Epac2−/− mice on HFD (Epac2−/− HFD). Isolated ex vivo mice hearts were perfused in a constant pressure Langendorff mode, and exposed to 30min of global ischemia (GI) and 60min of reperfusion. Endpoints were infarct size and functional recovery. Results: All groups fed a HFD presented with significantly enhanced body weight, visceral fat content and reduced glucose clearance compared to corresponding ND groups. Although the HFD cohorts presented with an overall comparable systemic capability to clear glucose, the Epac1−/− HFD group presented with glucose levels slightly above the human diabetes criteria at the end of the intraperitoneal glucose tolerance test (ipGTT). Moreover, the HFD significantly reduced infarct size in both wild type (wt HFD 41.3 ± 5.5% vs. wt ND 58.0 ± 9.8%, p < 0.05) and Epac2−/− cohorts (Epac2−/− HFD 34.4 ± 7.2% vs. Epac2−/− ND 56.5 ± 3.8%, p < 0.05). Interestingly, however, the HFD did not reduce infarct size in Epac1−/− deficient mice hearts (Epac1−/− HFD 65.1 ± 5.1% vs. Epac1−/− ND 56.1 ± 3.5%, ns.). Conclusion: Epac1-dependent signaling is involved in mediating the cardioprotection afforded by long-term feeding of an obesogenic high fat diet in mice hearts