Increased Glucose Activity in Subgenual Anterior Cingulate and Hippocampus of High Performing Older Adults, Despite Amyloid Burden

BACKGROUND: Individuals at 80 years of age or above with exceptional memory are considered SuperAgers (SA), an operationalized definition of successful cognitive aging. SA showed increased thickness and altered functional connectivity in the anterior cingulate cortex as a neurobiological signature. However, their metabolic alterations are yet to be uncovered. OBJECTIVE: Herein, a metabolic (FDG-PET), amyloid (PIB-PET), and functional (fMRI) analysis of SA were conducted. METHODS: Ten SA, ten age-matched older adults (C80), and ten cognitively normal middle-aged (C50) adults underwent cognitive testing and multimodal neuroimaging examinations. Anterior and posterior regions of the cingulate cortex and hippocampal areas were primarily examined, then subregions of anterior cingulate were segregated. RESULTS: The SA group showed increased metabolic activity in the left and right subgenual anterior cingulate cortex (sACC, p   0.05). The SA group also presented decreased connectivity between right sACC and posterior cingulate (p <  0.005, corrected) as compared to that of the C80 group. CONCLUSION: These results support the key role of sACC and hippocampus in SA, even in the presence of amyloid deposition. It also suggests that sACC may be used as a potential biomarker in older adults for exceptional memory ability. Further longitudinal studies measuring metabolic biomarkers may help elucidate the interaction between these areas in the cognitive aging process

Rela??o entre o uso de inibidor da enzima conversora de angiotensina e desfechos no p?s-operat?rio de cirurgia de revasculariza??o mioc?rdica

Made available in DSpace on 2015-04-14T13:35:11Z (GMT). No. of bitstreams: 1 430806.pdf: 508330 bytes, checksum: 67218141db4f620b12fee6f11264cd1e (MD5) Previous issue date: 2011-03-16INTRODU??O : Os Inibidores da enzima conversora de angiotensina (IECA) tem se mostrado ben?ficos na preven??o de ?bito, infarto e acidente vascular encef?lico em pacientes portadores de doen?a arterial coronariana. Entre outros efeitos, atuam no controle da hipertens?o arterial e do remodelamento card?aco, diminuindo a progress?o para insufici?ncia card?aca. No entanto, n?o h? consenso quanto ? sua indica??o em pacientes que ser?o submetidos a cirurgia de revasculariza??o mioc?rdica (CRM). OBJETIVO : Avaliar a rela??o entre o uso pr?-operat?rio de IECA e desfechos cl?nicos ap?s a realiza??o da CRM. M?TODOS : Estudo de coorte retrospectivo. Foram inclu?dos dados de 3.139 pacientes consecutivos que foram submetidos ? CRM isolada em hospital terci?rio universit?rio brasileiro entre janeiro de 1996 e dezembro de 2009. O seguimento se deu at? a alta hospitalar ou ?bito. Desfechos cl?nicos no p?s-operat?rio foram analisados entre os usu?rios e os n?o-usu?rios de IECA nos pr?-operat?rio. RESULTADOS : Cinquenta e dois porcento (1.635) dos pacientes receberam IECA no pr?-operat?rio. O uso de IECA no pr?-operat?rio foi preditor independente de necessidade de suporte inotr?pico (RC 1,24; IC 1,01-1,47; P=0,01), de insufici?ncia renal aguda (RC 1,23; IC 1,01-1,73; P=0,04) e de evolu??o para fibrila??o atrial (RC 1,32; IC 1,02-1,7; P=0,03) no p?s-operat?rio. A taxa de mortalidade entre os pacientes que receberam ou n?o IECA no pr?-operat?rio foi semelhante (10,3 vs. 9,4%, P=0,436), bem como a incid?ncia de infarto agudo do mioc?rdio e acidente vascular encef?lico (15,6 vs. 15,0%, P=0,694; e 3,4 vs 3,5%, P=0,963, respectivamente). CONCLUS?O : O uso pr?-operat?rio de IECA foi associado a uma maior necessidade de suporte inotr?pico no p?s-operat?rio, bem como a uma maior incid?ncia de IRA e FA, n?o estando associado a um aumento da taxa de IAM, AVE e ?bito

Avaliação cognitiva de condutores automotivos idosos: revisão integrativa

O presente estudo investigou a eficiência de testes cognitivos na avaliação da capacidade de condução automotiva em idosos, através de uma revisão integrativa da literatura, utilizando artigos publicados na base de dados PubMed, entre outubro de 2011 a outubro de 2016. Foram identificados apenas 15 artigos. Os testes mais investigados foram o Mini Exame do Estado Mental (MEEM), o Teste das Trilhas e o Desenho do relógio, apresentando resultados contraditórios e pouco consistentes. Nenhum dos estudos inclui a população brasileira. Até o momento não há uma bateria de testes recomendada para avaliação de condutores idosos que possa auxiliar na importante tarefa de aconselhar a continuação ou interrupção da atividade em condutores idosos.El presente estudio investigó la eficiencia de las pruebas cognitivas en la evaluación de la capacidad de conducción automotriz en ancianos, a través de una revisión integrativa de la literatura, utilizando artículos publicados en la base de datos PubMed, entre octubre de 2011 hasta octubre de 2016. Se identificaron sólo 15 artículos. Las pruebas más investigadas fueron el Mini Examen del Estado Mental (MEEM), el Test del Trazo y el Dibujo del reloj, presentando resultados contradictorios y poco consistentes. Ninguno de los estudios incluye a la población brasileña. Hasta el momento no hay una batería de pruebas recomendada para evaluación de conductores ancianos que pueda auxiliar en la importante tarea de aconsejar la continuación o interrupción de la actividad en conductores ancianos.The following study investigated the effectiveness of cognitive tests assessing car driving ability in the elderly through an integrative review of the literature, using articles published between October 2011 to October 2016 in the PubMed database. Only 15 articles were identified. The most investigated tests were the Mini Mental State Examination (MMSE), the Trial Making Test and the Design of the clock, presenting contradictory and inconsistent results. None of the studies dealt with Brazilian drivers. To date, there has been no recommended battery of tests to help determine cognitive fitness to drive in elderly drivers

Secondary Dyslipidemia In Obese Children - Is There Evidence For Pharmacological Treatment?

Abstract Background: Long-term safety, effectiveness and criteria for treatment with statins in children are still unclear in clinical practice. There is very limited evidence for the use of medication to treat children with dyslipidemia secondary to obesity who do not respond well to lifestyle modification. Objective: Systematic review of randomized clinical trials of statin use to treat children and adolescents with dyslipidemia secondary to obesity. Methods: We performed a search in PubMed, EMBASE, Bireme, Web of Science, Cochrane Library, SciELO, and LILACS for data to evaluate the effect of statins on: improvement of surrogate markers of coronary artery disease in clinical outcomes of adulthood; increased serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and apolipropotein B (APOB); and decreased serum levels of high-density lipoprotein cholesterol (HDL-C) from inception to February 2016. Participants were children and adolescents. Results: Of the 16793 potentially relevant citations recovered from the electronic databases, no randomized clinical trials fulfilled the inclusion criteria for children with dyslipidemia secondary to obesity. Conclusions: We found no specific evidence to consider statins in the treatment of hypercholesterolemia secondary to obesity in children. The usual practice of extrapolating findings from studies in genetic dyslipidemia ignores the differences in long-term cardiovascular risks and the long-term drug treatment risks, when compared to recommendation of lifestyle changes. Randomized clinical trials are needed to understand drug treatment in dyslipidemia secondary to obesity

Instruments for evaluating financial management capacity among the elderly: an integrative literature review

<div><p>Abstract Objective: To identify tools available in literature for assessing the financial management capacity of elderly persons with and without cognitive deficit or impairment. Methods: An integrative literature review was performed. Scientific publications indexed in the PubMed, LILACS (Latin American and Caribbean Health Sciences Literature), Psychology Index and Cochrane Library databases by November 2015 were evaluated. Results: Of the 609 articles obtained from the databases, 29 were considered eligible for this review, and involved 11 instruments for the evaluation of financial management capacity, the most cited of which was the Financial Capacity Instrument (FCI). Conclusion: There are several scales and instruments available which are used to investigate both daily and instrumental activities of daily living, which allow the independence and effective functioning of the elderly on a day to day basis to be verified. Non-Brazilian literature also describes specific instruments for the assessment of financial management capacity. However, no references to a specific scale that evaluates this construct and which has been validated and adapted for the Brazilian population were identified.</p></div