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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The present study reports new and unexpected results of cognitive abnormalities among human immunodeficiency virus type 1 (HIV-1) asymptomatic subjects in the Multicenter AIDS Cohort Study. The major purpose of our analyses is to estimate the separate and combined effects of serostatus and education level on the prevalence of cognitive abnormality. Cognitive "abnormality" was defined as performance that deviated > or = 2 SDs below the mean of the total seronegative group on at least one of the five neuropsychological screening tests (Grooved Pegboard, Verbal Fluency, Digit Span, Symbol Digit Modalities, Rey Auditory Verbal Learning). The predicted prevalence of cognitive abnormality was 38% in seropositive individuals with no more than 12 years of education, compared with < 17% in the other education-serostatus groups. This interaction between education level and serostatus remained after controlling for the possible confounding effects of age, ethnicity, CD4 level, depression, prior drug history, and learning disability using logistic regression. To account for these findings, we suggest that low education might reflect an indirect index of lower reserve capacity (i.e., a risk factor) that lowers the threshold for neuropsychological abnormalities in cases of early HIV-1 infection.
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PMID:Low education as a possible risk factor for cognitive abnormalities in HIV-1: findings from the multicenter AIDS Cohort Study (MACS). 848 13

A cross-sectional study, based on an epidemiological register, was carried out to describe the prevalence of disabilities, felt needs and use of services for adults with learning disability and to compare outcomes of reported morbidity, stress and satisfaction among their informal carers. Subjects included 2117 adults and 982 carers known to specialist services in Leicestershire. Behavioural and psychological problems and epilepsy were the main disabilities in adults. The leading unmet needs reported by residential carers were for daycare and other forms of residence, and those reported by informal carers were for financial help, long-term social support, respite care and housing adaptations. Informal carers reported 40% more limiting health disorders compared to the general population, with depression almost four times more common among female carers. Divisions between health and social care are causing inequality and hardship. Lifelong informal carers need options for independence. The increase over time in the prevalence of adults with severe learning disabilities adds to the evidence that more resources for care are needed. Epidemiological registers and methods should be developed to aid purchasing and provision for this client group.
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PMID:Community care for adults with learning disability and their carers: needs and outcomes from the Leicestershire register. 873 77

This paper investigates differences in the nature and frequency of psychiatric symptoms reported by patients with learning disability and key informants. The study involved psychiatric assessment of 100 patients with learning disabilities and key informants using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have a learning disability. There was considerable disagreement between respondent and informant interviews: only 40.7% of cases were detected by both interviews. Respondents were more likely to report on autonomic symptoms and certain psychotic phenomena. Other anxiety and depression symptoms were more frequently reported by informants. The results indicate that it is crucial for sensitive case detection to complete both interviews where possible. If the respondent cannot be interviewed, panic disorder or phobias may be particularly difficult to detect.
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PMID:Respondent and informant accounts of psychiatric symptoms in a sample of patients with learning disability. 890 33

The study investigated the relationship between reflective or impulsive cognitive style, metacognitive functioning, and depression in young adolescents. Metacognitive functioning (metacognitive knowledge about reading and memory, monitoring of text comprehension) and self-reported depressive feelings were analyzed in a group of subjects who showed a Reflective or Impulsive cognitive style. The sample consisted of 56 junior high-school students (Grades 6, 7, and 8) selected from a larger original group of 61 subjects. We excluded from the original group those with an IQ below 75 on both the Verbal and Performance subscales on the short form of the WISC-R, those reported by teachers to have a severe learning disability, and those that did not complete the test battery due to long absences from school. The reflective-impulsive cognitive style was identified with the Matching Familiar Figures Test-20. Using the median of the distribution for both Latency (17 sec. per item) and Errors (9 errors) on this task, the sample was divided in four partially overlapping subgroups: 16 with Impulsive cognitive style (Latency below the median, Errors above the median), 13 with Reflective cognitive style (Latency above the median, Error below the median), 4 fast and accurate (both scores below the median), and 11 slow and inaccurate (both scores above the median). Twelve subjects with one or both scores coinciding with the critical value (median) were excluded. Analysis showed that subjects with Impulsive cognitive style had significantly lower scores than those with Reflective cognitive style in monitoring of comprehension of text. No differences were found on monitoring by eighth graders, irrespective of cognitive style. No differences between the two groups were found in metacognitive knowledge. Subjects with Impulsive cognitive style had significantly higher scores than subjects with Reflective cognitive style on a self-rating scale for childhood depression, the Children's Depression Inventory. The implications of these data are discussed.
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PMID:Impulsive-reflective cognitive style, metacognition, and emotion in adolescence. 913 33

A. Digital EEG is an established substitute for recording, reviewing, and storing a paper EEG record. It is a clear technical advance over previous paper methods. It is highly recommended. (Class III evidence, Type C recommendation). B. EEG brain mapping and other advanced QEEG techniques should be used only by physicians highly skilled in clinical EEG, and only as an adjunct to and in conjunction with traditional EEG interpretation. These tests may be clinically useful only for patients who have been well selected on the basis of their clinical presentation. C. Certain quantitative EEG techniques are considered established as an addition to digital EEG in: C.1. Epilepsy: For screening for possible epileptic spikes or seizures in long-term EEG monitoring or ambulatory recording to facilitate subsequent expert visual EEG interpretation. (Class I and II evidence, Type A recommendation as a practice guideline). C.2. OR and ICU monitoring: For continuous EEG monitoring by frequency-trending to detect early, acute intracranial complications in the OR or ICU, and for screening for possible epileptic seizures in high-risk ICU patients. (Class II evidence, Type B recommendation as a practice option). D. Certain quantitative EEG techniques are considered possibly useful practice options as an addition to digital EEG in: D.1. Epilepsy: For topographic voltage and dipole analysis in presurgical evaluations. (Class II evidence, Type B recommendation). D.2. Cerebrovascular Disease: Based on Class II and III evidence, QEEG in expert hands may possibly be useful in evaluating certain patients with symptoms of cerebrovascular disease whose neuroimaging and routine EEG studies are not conclusive. (Type B recommendation). D.3. Dementia: Routine EEG has long been an established test used in evaluations of dementia and encephalopathy when the diagnosis remains unresolved after initial clinical evaluation. In occasional clinical evaluations, QEEG frequency analysis may be a useful adjunct to interpretation of the routine EEG when used in expert hands. (Class II and III evidence as a possibly useful test, Type B recommendation). E. On the basis of current clinical literature, opinions of most experts, and proposed rationales for their use, QEEG remains investigational for clinical use in postconcussion syndrome, mild or moderate head injury, learning disability, attention disorders, schizophrenia, depression, alcoholism, and drug abuse. (Class II and III evidence, Type D recommendation). F. On the basis of clinical and scientific evidence, opinions of most experts, and the technical and methodologic shortcomings, QEEG is not recommended for use in civil or criminal judicial proceedings. (Strong Class III evidence, Type E recommendation). G. Because of the very substantial risk of erroneous interpretations, it is unacceptable for any EEG brain mapping or other QEEG techniques to be used clinically by those who are not physicians highly skilled in clinical EEG interpretation. (Strong Class III evidence, Type E recommendation).
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PMID:Assessment of digital EEG, quantitative EEG, and EEG brain mapping: report of the American Academy of Neurology and the American Clinical Neurophysiology Society. 922 9

Alzheimer's disease (AD) patients with moderate dementia show losses in olfactory threshold, odor identification and odor memory. Sensitivity and specificity of olfactory testing is significant, with the greatest power of accurate diagnosis in the more cognitively loaded olfactory tasks. In patients with very mild AD or in patients at risk for the disease because of their mild cognitive impairment, losses are apparent for odor identification, odor recognition memory and odor threshold, with the best sensitivity in the identification task. Persons who are either heterozygous or homozygous for the epsilon 4 allele of apolipoprotein E (ApoE) have an increased risk of Alzheimer's disease, although they show no dementia in the preclinical period. Evidence of olfactory dysfunction in this population might be reflective of an incipient dementing process. We have recently examined olfactory function in a group of normal elderly persons who have undergone genetic testing for the Apoe4 allele. These individuals consisted of all normal control subjects at the University of California, San Diego (UCSD) Alzheimer's Disease Research Center (ADRC) who had undergone both the genetic testing and testing for olfactory function. All had been diagnosed as normal control participants by two different neurologists who applied the National Institute of Neurological Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINDS-ADRDA) criteria for dementia. Persons with a history of alcoholism, drug abuse, learning disability or neurologic or psychiatric illness (including depression) were excluded. In this population, persons with the Apoe4 allele showed significantly poorer odor identification than those without an epsilon 4 allele. Early appearance of olfactory deficits in the progression to AD in persons with the epsilon 4 allele suggests diagnostic utility in olfactory testing.
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PMID:Apolipoprotein E status is associated with odor identification deficits in nondemented older persons. 992 80

Digital EEG (DEEG) and quantitative EEG (QEEG) are recently developed tools present in many clinical situations. Besides showing didactic and research utility, they may also have a clinical role. Although a considerable amount of scientific literature has been published related to QEEG, many controversies still subsist regarding its clinical utilization. Clinical applications are: 1. DEEG is already an established substitute for conventional EEG, representing a clear technical advance. 2. Certain QEEG techniques are an established addition to DEEG for: 2a) screening for epileptic spikes or seizures in long-term recordings; 2b) Operation room and intensive care unit EEG monitoring. 3. Certain QEEG techniques are considered possible useful additions to DEEG: 3a) topographic voltage and dipole analysis in epilepsy evaluations; 3b) frequency analysis in cerebrovascular disease and dementia, mostly when other tests have been inconclusive. 4. QEEG remains investigational for clinical use in postconcussion syndrome, learning disability, attention disorders, schizophrenia, depression, alcoholism and drug abuse. EEG brain mapping and other QEEG techniques should be clinically used only by physicians highly skilled in clinical EEG interpretation and as an adjunct to traditional EEG work.
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PMID:[Guidelines for recording/analyzing quantitative EEG and evoked potentials. Part II: Clinical aspects]. 1034 40

Plasmalogens are glycerophospholipids of neural membranes containing vinyl ether bonds. Their synthetic pathway is located in peroxisomes and endoplasmic reticulum. The rate-limiting enzymes are in the peroxisomes and are induced by docosahexaenoic acid (DHA). Plasmalogens often contain arachidonic acid (AA) or DHA at the sn-2 position of the glycerol moiety. The receptor-mediated hydrolysis of plasmalogens by cytosolic plasmalogen-selective phospholipase A2 generates AA or DHA and lysoplasmalogens. AA is metabolized to eicosanoids. The mechanism of signaling with DHA is not known. The plasmalogen-selective phospholipase A2 differs from other intracellular phospholipases A2 in molecular mass, kinetic properties, substrate specificity, and response to glycosaminoglycans, gangliosides, and sialoglycoproteins. A major portion of [3H]DHA incorporated into neural membranes is found at the sn-2 position of ethanolamine glycerophospholipids. Studies with a mutant cell line defective in plasmalogen biosynthesis indicate that the incorporation of DHA is reduced in this RAW 264.7 cell line by 50%. In contrast, the incorporation of AA remains unaffected. This is reversed completely when the growth medium is supplemented with sn-1-hexadecylglycerol, suggesting that DHA can be selectively targeted for incorporation into plasmalogens. We suggest that deficiencies of DHA and plasmalogens in peroxisomal disorders, Alzheimer's disease (AD), depression, and attention deficit hyperactivity disorders (ADHD) may be responsible for abnormal signal transduction associated with learning disability, cognitive deficit, and visual dysfunction. These abnormalities in the signal-transduction process can be partially corrected by supplementation with a diet enriched with DHA.
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PMID:Plasmalogens, phospholipase A2, and docosahexaenoic acid turnover in brain tissue. 1147 81

Aim of this study was to investigate whether specific temperamental features were associated with anxiety and depressive disorders in adolescents, in their siblings and in their parents. Thirty adolescents with Anxiety disorders and 25 with both Anxiety and Depressive disorders were compared to 25 adolescents with learning disorders and to 28 normal subjects. Temperament in subjects and relatives was assessed by their parents with the EAS questionnaire. Subjects with Anxiety and Anxiety-Depression and their siblings showed higher scores on Emotionality and Shyness than Learning Disability and Normal subjects. Mothers and fathers of subjects from the Anxiety-Depression group had the highest Emotionality score. These findings suggest that both Emotionality and Shyness are prominent temperamental features in adolescents with anxiety with or without depression, and in their parents and siblings.
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PMID:Temperament in adolescents with anxiety and depressive disorders and in their families. 1256 25

The concept of DAMP (deficits in attention, motor control, and perception) has been in clinical use in Scandinavia for about 20 years. DAMP is diagnosed on the basis of concomitant attention deficit/hyperactivity disorder and developmental coordination disorder in children who do not have severe learning disability or cerebral palsy. In clinically severe form it affects about 1.5% of the general population of school age children; another few per cent are affected by more moderate variants. Boys are overrepresented; girls are currently probably underdiagnosed. There are many comorbid problems/overlapping conditions, including conduct disorder, depression/anxiety, and academic failure. There is a strong link with autism spectrum disorders in severe DAMP. Familial factors and pre- and perinatal risk factors account for much of the variance. Psychosocial risk factors appear to increase the risk of marked psychiatric abnormality in DAMP. Outcome in early adult age was psychosocially poor in one study in almost 60% of unmedicated cases. There are effective interventions available for many of the problems encountered in DAMP.
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PMID:Deficits in attention, motor control, and perception: a brief review. 1450 Mar 12


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