Prevalence of Schizophrenia in Idiopathic Normal Pressure Hydrocephalus

BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive and potentially treatable neurodegenerative disease affecting elderly people, characterized by gait impairment and ventricular enlargement in brain imaging. Similar findings are seen in some patients with schizophrenia (SCZ).OBJECTIVE: To determine the prevalence of SCZ among patients suffering from probable or possible iNPH and the specific effects of comorbid SCZ on the outcome of the cerebrospinal fluid (CSF) shunting.METHODS: All medical records of the 521 iNPH patients in the NPH registry were retrospectively analyzed from 1991 until 2017. The prevalence of comorbidity of SCZ was determined and compared to that of general aged (≥65 yr) population in Finland.RESULTS: We identified a total of 16 (3.1%) iNPH patients suffering from comorbid SCZ. The prevalence of SCZ among the iNPH patients was significantly higher compared to the general population (3.1% vs 0.9%, P CONCLUSION: SCZ seems to occur 3 times more frequently among iNPH patients compared to the general aged population in Finland. The outcome of the treatment was not affected by comorbid SCZ and therefore iNPH patients suffering from comorbid SCZ should not be left untreated. These results merit validation in other populations. In addition, further research towards the potential connection between these chronic conditions is warranted.</p

Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Triggers, Causes, and Outcome (SECRETO): Rationale and design

Background: Worldwide, about 1.3 million annual ischaemic strokes (IS) occur in adults aged <50 years. Of these early-onset strokes, up to 50% can be regarded as cryptogenic or associated with conditions with poorly documented causality like patent foramen ovale and coagulopathies. Key hypotheses/aims: (1) Investigate transient triggers and clinical/sub-clinical chronic risk factors associated with cryptogenic IS in the young; (2) use cardiac imaging methods exceeding state-of-the-art to reveal novel sources for embolism; (3) search for covert thrombosis and haemostasis abnormalities; (4) discover new disease pathways using next-generation sequencing and RNA gene expression studies; (5) determine patient prognosis by use of phenotypic and genetic data; and (6) adapt systems medicine approach to investigate complex risk-factor interactions. Design: Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725) is a prospective multi-centre case–control study enrolling patients aged 18–49 years hospitalised due to first-ever imaging-proven IS of undetermined etiology. Patients are examined according to a standardised protocol and followed up for 10 years. Patients are 1:1 age- and sex-matched to stroke-free controls. Key study elements include centralised reading of echocardiography, electrocardiography, and neurovascular imaging, as well as blood samples for genetic, gene-expression, thrombosis and haemostasis and biomarker analysis. We aim to have 600 patient– control pairs enrolled by the end of 2018. Summary: SECRETO is aiming to establish novel mechanisms and prognosis of cryptogenic IS in the young and will provide new directions for therapy development for these patients. First results are anticipated in 2019

Why Does the Health-Related Quality of Life in Idiopathic Normal-Pressure Hydrocephalus Fail to Improve Despite the Favorable Clinical Outcome?

OBJECTIVE: Occasionally, a favorable clinical diseasespecific outcome does not reflect into improved generic health-related quality of life (HRQoL) in patients with idiopathic normal-pressure hydrocephalus (iNPH) at 1 year after the installation of a cerebrospinal fluid shunt. Our aim was to identify factors causing this discrepancy. METHODS: The 1-year HRQoL outcomes of 141 patients with iNPH were evaluated with the generic 15D instrument, in which the minimum clinically important change/difference on the 0-1 scale has been estimated to be +/- 0.015.A 12-point iNPH grading scale (iNPHGS) was used as a clinical disease-specific outcome measure, in which a 1-point decrease is considered to be clinically important. We identified 29 (21%) patients with iNPH from our prospective study whose HRQoL deteriorated or remained the same despite of a favorable iNPHGS outcome. We analyzed this discrepancy using patients' clinical variables and characteristics. RESULTS: Multivariate binary logistic regression analysis indicated that a greater (worse) iNPHGS score at baseline (adjusted odds ratio [OR], 1.7; 95% confidence interval [CI] 1.3-2.3; P <0.001), comorbid chronic pulmonary disease (40% vs. 20%; adjusted OR 17.8; 95% CI 3.6-89.9; P <0.001), and any comorbid nonmetastatic tumor (62% vs. 17%; adjusted OR 11.5; 95% CI 1.5-85.3; P [0.017) predicted discrepancy between iNPHGS and 15D outcomes. - CONCLUSIONS: Frail patients suffering from certain preexisting comorbidities may not experience improvement in generic HRQoL despite of a favorable clinical diseasespecific response. Acknowledging the comorbidity burden of the patient may help clinicians and the patients to understand the conflict between patient-reported and clinical outcomes.Peer reviewe

Study content integreated learning in 1st grade

Šī diplomdarba temats ir “Mācību satura integrēta apguve 1.klasē. ” Tā mērķis ir pētīt un analizēt mācību satura integrētu procesu 1.klasē un apkopot pētījuma rezultātus. Tika vadītas septiņpadsmit nodarbības 1.klases skolēniem dažādos mācību priekšmetos, lai noskaidrotu, kuras mācību metodes un paņēmieni ir piemērotāki integrēta satura apguvē. Empīriskā pētījuma izmantotās metodes: novērošana, anketēšana un empīrisko datu analīze, vadīto mācību stundu analīze. Darba nobeigumā ir secinājumi, izmantotās literatūras avotu saraksts, pielikums, kurā ietilpst anketa, bērnu darbi un vadīto mācību stundu plāni. Darba vizualizācijai izmantoti 3 attēli. Pētījums veikts Kalnciema pagasta vidusskolā. Bakalaura darba apjoms 69 lappuses. Darbs ietver 37 literatūras avotus un 3 pielikumus. Atslēgas vārdi: integrēts mācību saturs, integrētas mācību stundas, mācību metodes un paņēmieni, daudzveidīgi materiāli.The theme of this annual paper is “Study content integreated learning in 1st grade.” Its aim is to study and analyze the integrated process of study content in the 1st grade and to summarize the research results. Seventeen classes were conducted for 1st grade students in different subjects to find out which teaching methods and techniques are more suitable for learning integrated content. Methods used in the empirical research: observation, questionnaire and analysis of empirical data, analysis of conducted lessons. At the end of the work there are conclusions, a list of used literature sources, an appendix, which includes a questionnaire, children's works and lesson plans. 3 images were used to visualize the work. The research was conducted in Kalnciems Parish Secondary School. Diploma Paper contains 69 pages, 37 literature sources and 3 appendixes. Keywords: integrated teaching content, integrated lessons, teaching methods and techniques, diverse materials

Cerebrospinal fluid biomarker and brain biopsy findings in idiopathic normal pressure hydrocephalus

Objective: To investigate the role of soluble APP (sAPP) and amyloid beta (Ab) isoforms, proinflammatory cytokines, and biomarkers of neuronal damage in the cerebrospinal fluid (CSF) in relation to brain biopsy Ab and hyperphosphorylated tau (HPt) findings. Methods: The study population comprised 102 patients with possible NPH with cortical brain biopsies, ventricular and lumbar CSF samples, and DNA available. The final clinical diagnoses were: 53 iNPH (91% shunt-responders), 26 AD (10 mixed iNPH+AD), and 23 others. Biopsy samples were immunostained against Ab and HPt. CSF levels of AD-related biomarkers (Ab42, p-tau, total tau), non-AD-related Ab isoforms (Ab38, Ab40), sAPP isoforms (sAPPa, sAPPb), proinflammatory cytokines (several interleukins (IL), interferon-gamma, monocyte chemoattractant protein-1, tumor necrosis factor-alpha) and biomarkers of neuronal damage (neurofilament light and myelin basic protein) were measured. All patients were genotyped for APOE. Results: Lumbar CSF levels of sAPP alpha were lower (p&lt;0.05) in patients with shunt-responsive iNPH compared to non-iNPH patients. sAPPb showed a similar trend (p = 0.06). CSF sAPP isoform levels showed no association to Ab or HPt in the brain biopsy. Quantified Ab load in the brain biopsy showed a negative correlation with CSF levels of Ab42 in ventricular (r = 20.295, p = 0.003) and lumbar (r = 20.356, p = 0.01) samples, while the levels of Ab38 and Ab40 showed no correlation. CSF levels of proinflammatory cytokines and biomarkers of neuronal damage did not associate to the brain biopsy findings, diagnosis, or shunt response. Higher lumbar/ventricular CSF IL-8 ratios (p&lt;0.001) were seen in lumbar samples collected after ventriculostomy compared to the samples collected before the procedure. Conclusions: The role of sAPP isoforms in iNPH seems to be independent from the amyloid cascade. No neuroinflammatory background was observed in iNPH or AD

Prevalence of Schizophrenia in Idiopathic Normal Pressure Hydrocephalus

BACKGROUND Idiopathic normal pressure hydrocephalus (iNPH) is a progressive and potentially treatable neurodegenerative disease affecting elderly people, characterized by gait impairment and ventricular enlargement in brain imaging. Similar findings are seen in some patients with schizophrenia (SCZ). OBJECTIVE To determine the prevalence of SCZ among patients suffering from probable or possible iNPH and the specific effects of comorbid SCZ on the outcome of the cerebrospinal fluid (CSF) shunting. METHODS All medical records of the 521 iNPH patients in the NPH registry were retrospectively analyzed from 1991 until 2017. The prevalence of comorbidity of SCZ was determined and compared to that of general aged (65 yr) population in Finland. RESULTS We identified a total of 16 (3.1%) iNPH patients suffering from comorbid SCZ. The prevalence of SCZ among the iNPH patients was significantly higher compared to the general population (3.1% vs 0.9%, P <.001). All iNPH patients with comorbid SCZ were CSF shunted and 12 (75%) had a clinically verified shunt response 3 to 12 mo after the procedure. The CSF shunt response rate did not differ between patients with and without comorbid SCZ. CONCLUSION SCZ seems to occur 3 times more frequently among iNPH patients compared to the general aged population in Finland. The outcome of the treatment was not affected by comorbid SCZ and therefore iNPH patients suffering from comorbid SCZ should not be left untreated. These results merit validation in other populations. In addition, further research towards the potential connection between these chronic conditions is warranted.Peer reviewe

CSF Aβ and sAPP isoforms in different brain biopsy groups.

<p>Scatterplots of amyloid beta 1–38 (Aβ38) (A), Aβ40 (B), Aβ42 (C), soluble amyloid precursor protein alpha (sAPPα) (D), and beta (sAPPβ) (E) in groups of positive/negative Aβ and hyperphosphorylated tau (HPτ) immunoreactivity in brain biopsy are presented. Cases are color-labeled according to their <i>APOE-ε4</i> status. <i>P</i>-values were determined using a Kruskal–Wallis H test and post-hoc Mann–Whitney U test with Bonferroni correction. Only statistically significant <i>p</i>-values are shown.</p

Lumbar/ventricular CSF IL-8 ratio in relation to time between the CSF samples.

<p>Scatterplot of lumbar/ventricular cerebrospinal fluid (CSF) interleukin 8 (IL-8) ratio in individual cases in relation to the time difference between lumbar and ventricular samples is presented. Cases are color-labeled according to whether lumbar CSF sample was collected before or after the ventricular sample.</p