Effectiveness and costs of phototest in dementia and cognitive impairment screening

<p>Abstract</p> <p>Background</p> <p>To assess and compare the effectiveness and costs of Phototest, Mini Mental State Examination (MMSE), and Memory Impairment Screen (MIS) to screen for dementia (DEM) and cognitive impairment (CI).</p> <p>Methods</p> <p>A phase III study was conducted over one year in consecutive patients with suspicion of CI or DEM at four Primary Care (PC) centers. After undergoing all screening tests at the PC center, participants were extensively evaluated by researchers blinded to screening test results in a Cognitive-Behavioral Neurology Unit (CBNU). The gold standard diagnosis was established by consensus of expert neurologists. Effectiveness was assessed by the proportion of correct diagnoses (diagnostic accuracy [DA]) and by the kappa index of concordance between test results and gold standard diagnoses. Costs were based on public prices and hospital accounts.</p> <p>Results</p> <p>The study included 140 subjects (48 with DEM, 37 with CI without DEM, and 55 without CI). The MIS could not be applied to 23 illiterate subjects (16.4%). For DEM, the maximum effectiveness of the MMSE was obtained with different cutoff points as a function of educational level [k = 0.31 (95% Confidence interval [95%CI], 0.19-0.43), DA = 0.60 (95%CI, 0.52-0.68)], and that of the MIS with a cutoff of 3/4 [k = 0.63 (95%CI, 0.48-0.78), DA = 0.83 (95%CI, 0.80-0.92)]. Effectiveness of the Phototest [k = 0.71 (95%CI, 0.59-0.83), DA = 0.87 (95%CI, 0.80-0.92)] was similar to that of the MIS and higher than that of the MMSE. Costs were higher with MMSE (275.9 ± 193.3€ [mean ± sd euros]) than with Phototest (208.2 ± 196.8€) or MIS (201.3 ± 193.4€), whose costs did not significantly differ. For CI, the effectiveness did not significantly differ between MIS [k = 0.59 (95%CI, 0.45-0.74), DA = 0.79 (95%CI, 0.64-0.97)] and Phototest [k = 0.58 (95%CI, 0.45-0.74), DA = 0.78 (95%CI, 0.64-0.95)] and was lowest for the MMSE [k = 0.27 (95%CI, 0.09-0.45), DA = 0.69 (95%CI, 0.56-0.84)]. Costs were higher for MMSE (393.4 ± 121.8€) than for Phototest (287.0 ± 197.4€) or MIS (300.1 ± 165.6€), whose costs did not significantly differ.</p> <p>Conclusion</p> <p>MMSE is not an effective instrument in our setting. For both DEM and CI, the Phototest and MIS are more effective and less costly, with no difference between them. However, MIS could not be applied to the appreciable percentage of our population who were illiterate.</p

A Potential Route to Reduce Ischemia/Reperfusion Injury in Organ Preservation

The pathophysiological process of ischemia and reperfusion injury (IRI), an inevitable step in organ transplantation, causes important biochemical and structural changes that can result in serious organ damage. IRI is relevant for early graft dysfunction and graft survival. Today, in a global context of organ shortages, most organs come from extended criteria donors (ECDs), which are more sensitive to IRI. The main objective of organ preservation solutions is to protect against IRI through the application of specific, nonphysiological components, under conditions of no blood or oxygen, and then under conditions of metabolic reduction by hypothermia. The composition of hypothermic solutions includes osmotic and oncotic buffering components, and they are intracellular (rich in potassium) or extracellular (rich in sodium). However, above all, they all contain the same type of components intended to protect against IRI, such as glutathione, adenosine and allopurinol. These components have not changed for more than 30 years, even though our knowledge of IRI, and much of the relevant literature, questions their stability or efficacy. In addition, several pharmacological molecules have been the subjects of preclinical studies to optimize this protection. Among them, trimetazidine, tacrolimus and carvedilol have shown the most benefits. In fact, these drugs are already in clinical use, and it is a question of repositioning them for this novel use, without additional risk. This new strategy of including them would allow us to shift from cold storage solutions to cold preservation solutions including multitarget pharmacological components, offering protection against IRI and thus protecting today's more vulnerable organs

Sphere rolling on the surface of a cone

We analyse the motion of a sphere that rolls without slipping on a conical surface having its axis in the direction of the constant gravitational field of the Earth. This nonholonomic system admits a solution in terms of quadratures. We exhibit that the only circular of the system orbit is stable and furthermore show that all its solutions can be found using an analogy with central force problems. We also discuss the case of motion with no gravitational field, that is, of motion on a freely falling cone.Comment: 12 pages, 2 figures, to be published in Eur J Phy

Isolement et identification sur culture cellulaire du virus de la gastro-entérite transmissible du porc

Un virus à effet cytolytique inhibé par l’action des sérums de référence T.G.E., sensible à l'éther et résistant à pH 3, a été isolé, pour la première fois en France, à partir de porcelets IOPS ayant manifesté un épisode gastro-entéritique consécutivement à l'inoculation d'un matériel cliniquement suspect de T.G.E

Composición corporal y evaluación de la dieta de jóvenes atletas de baloncesto masculino

Se estudiaron 12 atletas de 16-17 años, persiguiendo dos objetivos: caracterizar su composición corporal para conocer de forma rápida la condición física y determinar la ingesta media de energía y nutrientes y su adecuación a las necesidades específicas. Los resultados permiten concluir que 2 jugadores no están en la mejor condición física, uno por exceso de peso con un porcentaje de grasa superior al máximo recomendado (12%) y otro por déficit, con un IMC< 20. En cuanto a las dietas, existe un desequilibrio de 400 Kcal entre las necesidades energéticas y la ingesta. La contribución energética de los principios inmediatos refleja un escaso aporte de los hidratos de carbono (< 51%) y de las proteínas y por el contrario una excesiva contribución de los lípidos (38-36%), con una relación de ácidos grasos saturados:poliinsaturados:monoinsaturados de 1 : 0,5: 1,2. Las ingestas son deficitarias en Iodo y excesivas en el aporte de vitamina B12 y C

About the self-dual Chern-Simons system and Toda field theories on the noncommutative plane

The relation of the noncommutative self-dual Chern-Simons (NCSDCS) system to the noncommutative generalizations of Toda and of affine Toda field theories is investigated more deeply. This paper continues the programme initiated in $JHEP {\bf 10} (2005) 071$, where it was presented how it is possible to define Toda field theories through second order differential equation systems starting from the NCSDCS system. Here we show that using the connection of the NCSDCS to the noncommutative chiral model, exact solutions of the Toda field theories can be also constructed by means of the noncommutative extension of the uniton method proposed in $JHEP {\bf 0408} (2004) 054$ by Ki-Myeong Lee. Particularly some specific solutions of the nc Liouville model are explicit constructed.Comment: 24 page

The comparative diagnostic accuracy of the Mini Mental State Examination (MMSE) and the General Practitioner assessment of Cognition (GPCOG) for identifying dementia in primary care: a systematic review protocol

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Conventional Cervical Exercises Compared with a Mixed-Reality-Based Game in Asymptomatic Subjects: An Exploratory Crossover Pilot Study.

Mixed reality presents itself as a potential technological tool for the management of people with musculoskeletal disorders, without having as many adverse side effects as immersive virtual reality. The objective of this study was to explore the possibilities of a mixed-reality game, performing task-oriented cervical exercises compared to conventional therapeutic exercises in sensorimotor outcome measures in asymptomatic subjects. A randomized crossover pilot study was performed with two intervention groups: a mixed-reality group (MRG) and a conventional exercise group (CEG). The cervical joint position error test (CJPET) and deep cervical flexor endurance test (DCFET) were measured as sensorimotor outcomes. Statistically significant differences were found in the pre–post comparison in the DCFET for both groups (MRG: t = �����3.87, p < 0.01; CEG: t = �����4.01, p < 0.01) and in the extension of the CJPET for the MRG (t = 3.50, p < 0.01). The rest of the measurements showed no significant differences comparing both groups pre- and postintervention (p > 0.05). Mixed reality has apparently the same positive effects as conventional exercises in sensorimotor outcomes in asymptomatic subjects. These results could help in future studies with mixed virtual reality in the management of people with musculoskeletal disorders.post-print882 K

Diagnostic de la rage Observations faites au cours de l'examen de 1.000 prélèvements suspects

Lucas Alexandre, Carnero R., Picard Monique, Costes Colette, Lahellec Marcelle. Diagnostic de la rage. In: Bulletin de l'Académie Vétérinaire de France tome 123 n°3, 1970. pp. 161-172