Executive Function Deficits in Patients with Mild Cognitive Impairment: Exploring the Impact of Substance Use

Substance use is pervasive in the United States. With overdose deaths on the rise for the past decade, studies have examined the detrimental effects of a range of substances. Substance use has been shown to affect the domains of executive functioning, while diseases such as Human Immunodeficiency Virus (HIV) and Hepatitis-C (Hep-C) have been shown to increase the severity of these deficits when comorbid with substance use. Alzheimer’s Dementia (AD) also affects many of the same domains of executive functioning as substance use. However, because of the rapid degenerative nature of the disease, individuals clinically determined to have Mild Cognitive Impairment (MCI) with a risk of progression to AD are more uniform in symptom presentation and discerned deficits, and are therefore more feasible to examine. This study examined whether a history of substance abuse impairs executive function in a cumulative manner when comorbid with MCI with a clinically indicated risk of progression to AD. While those subject to both MCI and substance use history did have the lowest scores in all of the assessments and in each of the conditions measured, those differences were insignificant. The hypothesis was not supported, even though the trend in scores was in the predicted trajectory. These results and implications are discussed, while limitations and possible future research directions are outlined

Case Report: A Truck Driver with Pelvic Pain

Extraskeletal myxoid chondrosarcoma (EMC) is a relatively rare soft tissue malignancy, originally described in the 1950s and characterized as a distinct entity from chondrosarcoma of the bone in the 1970s. These tumors most commonly originate in the proximal extremities, and their occurrence in the genitourinary tract is exceedingly rare, with few case reports citing origination in its component organs. We present a clinical case report of an EMC originating from the base of the penis with significant local involvement of the bony pelvis

No. 4 - Agriculture and the WTO: Subsidies in the Cross Hairs

September 2003 saw trade talks pursuing the Doha Development Agenda at the Cancún WTO Ministerial Meeting collapse, primarily over the disagreements between rich and developing countries regarding agriculture. Despite the great pessimism that ensued, on August 1, 2004, WTO negotiators from 147 countries announced a breakthrough in negotiations to liberalize trade in agricultural products. The most striking aspect of this new framework agreement is the proposed elimination of agricultural subsidies by rich countries in return for developing countries opening up their markets to more imports. At the same time, WTO dispute resolution panels have delivered stunning decisions against the U.S. cotton subsidy program and the European Union\u27s sugar subsidies. Clearly agriculture trade policy will be a pivotal issue determining the failure or success of the Doha round. This conference featured noted experts from senior levels of government, the private sector, and the legal profession addressing current developments in multilateral negotiations and the WTO cases on agriculture and analyzing their impact on the future of the world agricultural market. It was presented on November 16, 2004, at the University of Georgia School of Law by the Dean Rusk Center–International, Comparative, and Graduate Legal Studies and the College of Agricultural and Environmental Sciences

Plasma exosome microRNAs are indicative of breast cancer

Table containing the clinicopathological features of the patient-derived xenograft (PDX) mice used in this study. (DOCX 13 kb

Impaired HA-specific T follicular helper cell and antibody responses to influenza vaccination are linked to inflammation in humans.

Funder: National Institute for Health Research (NIHR)Antibody production following vaccination can provide protective immunity to subsequent infection by pathogens such as influenza viruses. However, circumstances where antibody formation is impaired after vaccination, such as in older people, require us to better understand the cellular and molecular mechanisms that underpin successful vaccination in order to improve vaccine design for at-risk groups. Here, by studying the breadth of anti-haemagglutinin (HA) IgG, serum cytokines, and B and T cell responses by flow cytometry before and after influenza vaccination, we show that formation of circulating T follicular helper (cTfh) cells was associated with high-titre antibody responses. Using Major Histocompatability Complex (MHC) class II tetramers, we demonstrate that HA-specific cTfh cells can derive from pre-existing memory CD4+ T cells and have a diverse T cell receptor (TCR) repertoire. In older people, the differentiation of HA-specific cells into cTfh cells was impaired. This age-dependent defect in cTfh cell formation was not due to a contraction of the TCR repertoire, but rather was linked with an increased inflammatory gene signature in cTfh cells. Together, this suggests that strategies that temporarily dampen inflammation at the time of vaccination may be a viable strategy to boost optimal antibody generation upon immunisation of older people

Surgical perspectives from a prospective, nonrandomized, multicenter study of breast conserving surgery and adjuvant electronic brachytherapy for the treatment of breast cancer

<p>Abstract</p> <p>Background</p> <p>Accelerated partial breast irradiation (APBI) may be used to deliver radiation to the tumor bed post-lumpectomy in eligible patients with breast cancer. Patient and tumor characteristics as well as the lumpectomy technique can influence patient eligibility for APBI. This report describes a lumpectomy procedure and examines patient, tumor, and surgical characteristics from a prospective, multicenter study of electronic brachytherapy.</p> <p>Methods</p> <p>The study enrolled 65 patients of age 45-84 years with ductal carcinoma or ductal carcinoma in situ, and 44 patients, who met the inclusion and exclusion criteria, were treated with APBI using the Axxent^®electronic brachytherapy system following lumpectomy. The prescription dose was 34 Gy in 10 fractions over 5 days.</p> <p>Results</p> <p>The lumpectomy technique as described herein varied by site and patient characteristics. The balloon applicator was implanted by the surgeon (91%) or a radiation oncologist (9%) during or up to 61 days post-lumpectomy (mean 22 days). A lateral approach was most commonly used (59%) for insertion of the applicator followed by an incision site approach in 27% of cases, a medial approach in 5%, and an inferior approach in 7%. A trocar was used during applicator insertion in 27% of cases. Local anesthetic, sedation, both or neither were administered in 45%, 2%, 41% and 11% of cases, respectively, during applicator placement. The prescription dose was delivered in 42 of 44 treated patients.</p> <p>Conclusions</p> <p>Early stage breast cancer can be treated with breast conserving surgery and APBI using electronic brachytherapy. Treatment was well tolerated, and these early outcomes were similar to the early outcomes with iridium-based balloon brachytherapy.</p