RESUMO
Arbuscular mycorrhizal fungi (AMF) appear to be highly associated with arsenic (As) uptake in host plants because arsenate (As(V)) and phosphorus (P) share the same transporter, whereby AMF can enhance P uptake. A short-term experiment was conducted for low- (0 to 0.05 mM As) and high-affinity (0 to 2.5 mM As) uptake systems, to investigate the AMF role on As uptake mechanism in plants, which may explain As uptake kinetics in upland rice cultivar: Zhonghan 221. When concentration of As ranged from 0 to 0.05 mM, Funneliformis geosporum (Fg) significantly decreased arsenite (As(III)) and monomethylarsonicacid (MMA) uptake when (p < 0.05) compared to non-mycorrhizal (NM) treatment, since the major route for (As(III)) in rice roots-rice silicon transporter Lsi1 would be influenced by Fg inoculation at high As concentrations. Fg can also reduce As(V) uptake significantly (p < 0.05) under both uptake systems relative to NM treatment, whereas, Funneliformis mosseae (Fm) increased As(V) and MMA uptake in rice roots, with MMA uptake rate generally lower than As(III) and As(V). Using suitable AMF species inoculation with rice, As uptake and accumulation in rice grains can be reduced and the risk to human health, once consumed, can be minimized.
Assuntos
Arsênio/metabolismo , Arsenicais/metabolismo , Glomeromycota/metabolismo , Micorrizas/metabolismo , Oryza/metabolismo , Microbiologia do Solo , Poluentes do Solo/metabolismo , Biodegradação Ambiental , Cinética , Oryza/microbiologia , Especificidade da EspécieRESUMO
A pot trial was conducted to investigate the role of arbuscular mycorrhizal fungi (AMF) on arsenic (As) uptake of upland rice (Oryza sativa L.) cultivar, Zhonghan 221; where the following 3 species of Glomus geosporum (Gg), G. mosseae (Gm) and G. versiforme (Gv) were applied as single or combined inoculations. In general, Gm significantly enhanced (p<0.05) total As concentration in Zhonghan 221 when compared to the non mycorrhizal (NM) treatment. The treatment inoculated with Gg + Gm increased total phosphorus (P) uptake and decreased total As uptake in the ingestible rice parts (husks and grains). In terms of AMF colonization rates, Gm had significantly higher (p<0.05) average values of 57.3% and 66.6% when grown in As0 and As40 soils, respectively, in comparison to that of Gg and Gv, and finally dropped to 3.63% when grown in As80 soil. There was a significant difference (p<0.05) between single AMF species (Gg or Gv) and AMF mixture treatments (Gg + Gv, Gg + Gm, Gv + Gm and Gg + Gv + Gm) in terms of total As concentrations in rice. No significant correlation between AMF colonization rates and As uptake in grains (r = 0.150, p > 0.01) and total P (r = 0.002, p > 0.01) were observed.
Assuntos
Arsênio/análise , Micorrizas/metabolismo , Oryza/metabolismo , Raízes de Plantas/metabolismo , Arsênio/química , Biodegradação Ambiental , Biomassa , Glomeromycota/genética , Glomeromycota/metabolismo , Fósforo/química , Plântula/efeitos dos fármacos , Solo , Microbiologia do Solo , Poluentes do Solo/análise , Especificidade da EspécieRESUMO
The effects of arbuscular mycorrhizal fungi (AMF) -Glomus intraradices and G. geosporum on arsenic (As) and phosphorus (P) uptake by lowland (Guangyinzhan) and upland rice (Handao 502) were investigated in soil, spiked with and without 60 mg As kg(-1). In As-contaminated soil, Guangyinzhan inoculated with G. intraradices or Handao 502 inoculated with G. geosporum enhanced As tolerance, grain P content, grain yield. However, Guangyinzhan inoculated with G. geosporum or Handao 502 inoculated with G. intraradices decreased grain P content, grain yield and the molar ratio of grain P/As content, and increased the As concentration and the ratio of grain/straw As concentration. These results show that rice/AMF combinations had significant (p < 0.05) effects on grain As concentration, grain yield and grain P uptake. The variation in the transfer and uptake of As and P reflected strong functional diversity in AM (arbuscular mycorrhizal) symbioses.
Assuntos
Arsênio/toxicidade , Micorrizas/metabolismo , Oryza/efeitos dos fármacos , Poluentes do Solo/toxicidade , Adaptação Fisiológica , Aerobiose , Agricultura/métodos , Arsênio/análise , Arsênio/metabolismo , Oryza/microbiologia , Oryza/fisiologia , Fósforo/análise , Fósforo/metabolismo , Solo/química , Microbiologia do Solo , Poluentes do Solo/metabolismoRESUMO
OBJECTIVES: 1) To compare the 2-year completed suicide and reattempt rates in a preintervention group of Hong Kong Chinese suicide attempters (aged 65 years and older) who received standard care and a postintervention group enrolled in a regional elderly suicide prevention program (ESPP) that adopts a two-tiered multifaceted care management model and 2) to examine the trend of suicide rates in older adults aged 65 years and older in the pre- and postintervention periods. DESIGN: The first part is an observational cohort study with baseline, follow-up, and outcome data being identified from a clinical electronic registry. The second part examines changes in suicide rates from official mortality statistics. SETTING: A government-funded suicide intervention program serving catchment population (852,796 people aged 65 years and older) in Hong Kong, China. PARTICIPANTS: Suicide attempters (aged 65 years and older) presenting to old-age psychiatric service in the pre- and postintervention phases. MEASUREMENTS: 1) Two-year rates of completed suicide and suicide reattempt and 2) changes in population suicide rates in the pre- and postintervention periods. RESULTS: The 2-year completed suicide rate was 7.58% in the preintervention group (N = 66) and 1.99$% in the ESPP group (N = 351) Χ = 6.192; p value: 0.028; df = 1). Reattempt rates were not different. At a population level, suicide rate dropped significantly only in women aged 85 years and older, relative to the preintervention period. CONCLUSIONS: The ESPP was associated with a reduced rate of completed suicide in old-age suicide attempters and might have contributed to a fall of suicide rate in women aged 85 years and older.
Assuntos
Prevenção do Suicídio , Idoso , Idoso de 80 Anos ou mais , China/etnologia , Estudos de Coortes , Serviços Comunitários de Saúde Mental , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Distribuição de Poisson , Avaliação de Programas e Projetos de Saúde , Sistema de Registros , Fatores de Risco , Fatores Socioeconômicos , Suicídio/estatística & dados numéricos , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricosRESUMO
BACKGROUND: Ultrasonography (USG) and technetium-99m sestamibi (MIBI) scintigraphy are commonly used imaging modalities in the era of minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (pHPT). However, their relative importance and actual contribution to MIP have not been prospectively assessed. METHODS: A total of 100 consecutive pHPT patients planning for MIP were recruited. Both USG and MIBI findings were correlated with intraoperative findings and postoperative outcome. Clinicopathologic factors were examined for potential association with a correct localizing result. RESULTS: Thirty men and 70 women (age range 13 to 93 years [median 55.5]) were included in the study. The final pathology included 98 patients with solitary adenoma and 2 patients with multiglandular disease. The sensitivities, accuracies, and positive predicted values for USG and MIBI alone were 57% vs 89%, 56% vs 85%, and 97% vs 94%, respectively. Correctly localized adenomas were significantly heavier than incorrectly localized ones. CONCLUSIONS: MIBI is preferred over USG in pHPT patients planning for MIP. Weight of adenoma appeared to be the only clinicopathologic factor determining localization accuracy.
Assuntos
Adenoma/diagnóstico por imagem , Hiperparatireoidismo Primário/etiologia , Neoplasias das Paratireoides/diagnóstico por imagem , Tecnécio Tc 99m Sestamibi , Adenoma/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hiperplasia , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Doenças das Paratireoides/diagnóstico por imagem , Doenças das Paratireoides/cirurgia , Glândulas Paratireoides/patologia , Neoplasias das Paratireoides/cirurgia , Cuidados Pré-Operatórios , Estudos Prospectivos , Cintilografia , Sensibilidade e Especificidade , UltrassonografiaRESUMO
Surprisingly, the effect of acute diabetes on immunity has not been examined in detail. We, herein, show for the first time that untreated acute diabetes causes rapid lymphopenia followed by homeostatic T-cell proliferation. The diabetes-induced lymphopenia was associated with an immunosuppressed state that could be sufficiently strong to allow engraftment of fully allogeneic beta-cells or block rejection of islet transplants. In contrast, homeostatic proliferation and recovery of T-cell numbers were associated with islet rejection. Thus, the timing of islet transplant challenge in relation to diabetes induction was critical in determining whether islets were accepted or rejected. In addition, we tested whether diabetes-related immunosuppression could result in an overestimation of the efficacy of a tolerance-inducing protocol. Consistent with this possibility, a protocol targeting CD40L and ICOS that we have shown induces tolerance in diabetic recipients was unable to induce tolerance in non-diabetic recipients. The data uncover a previously unrecognized suppressive effect of diabetes on adaptive immunity. Furthermore, they suggest that the standard methods of testing new tolerance-inducing protocols in islet transplantation require modification and that diabetes itself can contribute to homeostatic proliferation, a process associated with autoimmunity and a resistance to tolerance induction.
Assuntos
Diabetes Mellitus Experimental/imunologia , Tolerância Imunológica , Ativação Linfocitária , Linfócitos T/imunologia , Animais , Corticosterona/biossíntese , Homeostase , Insulinoma/imunologia , Transplante das Ilhotas Pancreáticas/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos CBA , Camundongos Endogâmicos NOD , Estreptozocina , Transplante HomólogoRESUMO
We report the first case of successful surgical resection of a malignant phaeochromocytoma with tumour extension into vena cava and right atrium in a patient with multiple endocrine neoplasia type 2A. A 21-year-old woman with genetic confirmation of multiple endocrine neoplasia type 2A syndrome was diagnosed with a very rare case of malignant phaeochromocytoma with tumour thrombus extension into vena cava and right atrium causing Budd-Chiari syndrome. It posed a challenge to the surgeons with regard to complete tumour resection and vascular control. Reviewing the limited literature, surgical resection by means of cardiopulmonary bypass with hypothermic circulatory arrest has been reported with success in phaeochromocytoma with advance vascular involvement. Adopting this approach, adrenalectomy with complete thrombus excision by inferior vena cava exploration and right atriotomy were performed successfully by a multidisciplinary team.
Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Átrios do Coração/cirurgia , Neoplasias Cardíacas/cirurgia , Neoplasia Endócrina Múltipla Tipo 2a/complicações , Feocromocitoma/cirurgia , Trombose/cirurgia , Neoplasias das Glândulas Suprarrenais/complicações , Neoplasias das Glândulas Suprarrenais/diagnóstico , Adrenalectomia , Adulto , Síndrome de Budd-Chiari/etiologia , Síndrome de Budd-Chiari/cirurgia , Feminino , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico , Humanos , Invasividade Neoplásica , Feocromocitoma/complicações , Feocromocitoma/diagnóstico , Trombectomia , Trombose/etiologia , Veia Cava Inferior/cirurgiaRESUMO
Multiple endocrine neoplasia type 2B syndrome is rarely reported in Chinese patients. A 25-year-old Chinese male presented with full-blown clinical features of this syndrome, including bilateral phaeochromocytomas, medullary thyroid carcinoma, and characteristic phenotypic features. One-stage surgical treatment was performed and subsequent genetic analysis confirmed a point mutation at codon 918 in exon 16 of the RET proto-oncogene. The mutation was arising de novo as there was no corresponding mutation found in both his parents or younger sister. Data published to date suggest there is no difference in the genetic and pathophysiologic basis, nor clinical characteristics of multiple endocrine neoplasia type 2B in Chinese patients. As the disease can be lethal, early diagnosis by prompt recognition of the characteristic phenotypic features followed by surgical treatment should improve the outcome. Family screening is essential to identify at-risk family members for prophylactic treatment.
Assuntos
Neoplasia Endócrina Múltipla Tipo 2b/diagnóstico , Neoplasia Endócrina Múltipla Tipo 2b/cirurgia , Adrenalectomia , Adulto , Povo Asiático , Humanos , Metástase Linfática , Masculino , Neoplasia Endócrina Múltipla Tipo 2b/genética , Esvaziamento Cervical , Mutação Puntual , Proto-Oncogene Mas , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas c-ret , Receptores Proteína Tirosina Quinases/genética , TireoidectomiaRESUMO
Pancreatic neuroendocrine tumor is an uncommon disease, and surgery is the only potentially curative treatment even when there is hepatic metastasis. A patient undergoing concomitant laparoscopic distal pancreatectomy and hepatectomy for pancreatic polypeptidoma with a solitary liver metastasis is reported.
Assuntos
Carcinoma de Células das Ilhotas Pancreáticas/secundário , Laparoscopia/métodos , Neoplasias Hepáticas/secundário , Pancreatectomia/métodos , Neoplasias Pancreáticas/cirurgia , Polipeptídeo Pancreático/metabolismo , Carcinoma de Células das Ilhotas Pancreáticas/diagnóstico , Carcinoma de Células das Ilhotas Pancreáticas/metabolismo , Carcinoma de Células das Ilhotas Pancreáticas/patologia , Carcinoma de Células das Ilhotas Pancreáticas/cirurgia , Diagnóstico por Imagem , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/cirurgia , Metástase Linfática , Pessoa de Meia-Idade , Octreotida , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patologia , Compostos Radiofarmacêuticos , Esplenectomia/métodos , Tomografia Computadorizada por Raios X , Ultrassonografia de IntervençãoRESUMO
BACKGROUND: Laparoscopic resection has been increasingly reported for pancreatic insulinomas. This report evaluates our experience with surgical treatment for pancreatic insulinomas in this era of laparoscopy and reviews the application, safety, and outcome of this surgical approach reported in the literature. METHODS: In a consecutive series of 10 patients with pancreatic insulinomas, laparoscopic resection was performed for selected patients after routine preoperative localizations. The outcome of this operative strategy was reviewed together with reported cases involving laparoscopic resection of pancreatic insulinomas. RESULTS: Laparoscopic distal pancreatectomy or enucleation was performed for four patients with tumors located at the body or tail of the pancreas, whereas open enucleation was performed for six patients with tumors located at the pancreatic head. Pancreatic leak developed in one laparoscopic and two open enucleations. A review of reported cases in the literature showed that 61 of 69 attempted laparoscopic pancreatic resections for insulinomas were performed successfully. All except two tumors were located at the body or tail of the pancreas. For 42 cases with detailed information, 41 tumors at the pancreas body or tail were removed successfully by enucleation (n = 24) or distal pancreatic resection (n = 17), and one tumor at the pancreatic head was enucleated successfully. Pancreatic fistula, the most frequent complication, occurred in 8 (19%) of 42 laparoscopic resections. CONCLUSIONS: Laparoscopic resection of pancreatic insulinomas is safe and feasible for tumors located at the body or tail of the pancreas. Its application for tumors located at the pancreatic head needs further evaluation.
Assuntos
Insulinoma/cirurgia , Laparoscopia/métodos , Pancreatectomia/métodos , Neoplasias Pancreáticas/cirurgia , Adolescente , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Laparoscopia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pancreatectomia/estatística & dados numéricos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Minimally invasive surgery for primary hyperparathyroidism (pHPT) depends on both an accurate preoperative localization and the availability of intraoperative parathyroid hormone monitoring. METHODS: Patients with sporadic pHPT and one unequivocally enlarged parathyroid gland on preoperative imaging underwent endoscopic-assisted parathyroidectomy. Intraoperative rapid parathyroid hormone (quick PTH) monitoring was performed, and surgical success was confirmed when there was a >50% decrease in quick PTH level 10 min after excision as compared with the baseline level at induction. The surgical outcome and the use of preoperative localization, together with the role played by quick PTH assay in enhancing the operative success, were evaluated. RESULTS: From 1999 to 2002, 66 of 107 patients (62%) were selected for this approach. The accuracy of 99mTc-Sestamibi scintigraphy and ultrasonography was 97% and 70%, respectively. Conversion was required in four cases due to technical problems, and four additional patients failed to show a significant decline in quick PTH levels postexcision. Two patients underwent cervical exploration without the finding of any additional pathology, and another two patients had a delayed drop in quick PTH that was confirmed 30 min postexcision. All patients had a solitary adenoma and were cured of hypercalcemia during a median follow-up of 9 months. CONCLUSIONS: Minimally invasive endoscopic-assisted parathyroidectomy can be performed expeditiously in a select group of patients based on 99mTc-Sestamibi scintigraphy. The use of quick PTH assay can ensure surgical success, but careful interpretation of the results is mandatory.
Assuntos
Adenoma/cirurgia , Endoscopia/métodos , Hiperparatireoidismo/cirurgia , Neoplasias das Paratireoides/cirurgia , Paratireoidectomia/métodos , Adenoma/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hipercalcemia/etiologia , Hiperparatireoidismo/sangue , Hiperparatireoidismo/complicações , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Monitorização Intraoperatória , Hormônio Paratireóideo/sangue , Neoplasias das Paratireoides/diagnóstico por imagem , Valor Preditivo dos Testes , Cintilografia , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Resultado do Tratamento , UltrassonografiaRESUMO
We prospectively studied all patients admitted for total hip (THR) or knee (TKR) arthroplasty from July 2000 to February 2001. No pharmacological anticoagulation was given. All patients received a standardized postoperative rehabilitation regimen. Forty-six patients with known risk factors for deep vein thrombosis (DVT) were excluded. Eighty patients were studied (22 THR, 58 TKR; 55 women, 25 men). Mean age was 68 (30-90) years. Duplex ultrasonography on both lower limbs was performed on days 5-7 postoperatively. Location and extent of any thrombus were documented. In patients with distal DVT, a follow-up scan was done on days 10-14. If proximal propagation was observed, patients received full anticoagulation. If no propagation was detected, the distal thrombus was considered stable and clinical observation was continued. In the THR group, 1/22 and in the TKR group 9/58 were found to have distal DVT. All were asymptomatic. On follow-up scanning, none showed proximal propagation. All patients were followed up for at least 18 months, and none showed postthrombotic symptoms. Isolated distal DVT in "low-risk" Chinese patients after THR or TKR is not uncommon. Clinically they are usually "silent." If routine perioperative pharmacologic antithrombotic prophylaxis is not practiced, monitoring with duplex ultrasonography may need to be considered.
Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Ultrassonografia Doppler Dupla/métodos , Trombose Venosa/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Quadril/métodos , Artroplastia do Joelho/métodos , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Estudos Prospectivos , Fatores de Risco , Sensibilidade e Especificidade , Trombose Venosa/epidemiologia , Trombose Venosa/etiologiaRESUMO
Scarcely any information has been published on deep vein thrombosis (DVT) in Chinese patients after total hip arthroplasty (THA) or total knee arthroplasty (TKA). However, generally, no prophylaxis is given to patients who do not have conventional high-risk factors because they are believed to be at "low risk." We performed a prospective study on 80 such "low risk" patients undergoing THA or TKA (58 TKA and 22 THA) without prophylaxis and performed duplex ultrasonography on both lower limbs 6 to 8 days after surgery. A total of 22 patients (27.5%) showed ultrasonographic evidence of DVT. Eighteen (31%) TKAs and 4 (18.1%) THAs were complicated by DVT. Three patients showed bilateral involvement, all of whom underwent TKA. Two patients had symptomatic pulmonary embolism. The sensitivity and positive predictive value of the clinical examination was 27.2% and 31.6%, respectively. This study showed that patients who are labeled "low risk" for DVT actually had a significant risk and suggests that the current practice of providing prophylaxis to only patients deemed at "high risk" should be revised.
Assuntos
Artroplastia de Substituição/efeitos adversos , Complicações Pós-Operatórias , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Povo Asiático , Feminino , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Risco , Ultrassonografia Doppler Dupla , Trombose Venosa/diagnóstico por imagemRESUMO
Defatting is often required when skin flaps are transferred to the hand. We present three patients with skin flaps which were defatted using an arthroscopic shaver and a standard suction device. There were no complications and all three patients were satisfied with their outcomes. This method provided an effective treatment for our patients and did not require the purchase of specialised equipment.
Assuntos
Tecido Adiposo/cirurgia , Artroscopia , Traumatismos da Mão/cirurgia , Retalhos Cirúrgicos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Doença Diverticular do Colo/diagnóstico , Perfuração Intestinal/diagnóstico , Doença Aguda , Fatores Etários , Apendicite/diagnóstico , Diagnóstico Diferencial , Doença Diverticular do Colo/complicações , Doença Diverticular do Colo/cirurgia , Feminino , Humanos , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Pessoa de Meia-IdadeRESUMO
Deinococci with radiation resistance greater than that of Deinococcus radiophilus (ATCC 27603) were isolated from three commercial oyster extracts stored at 4, 20, and 30 degreesC. During storage the number of other bacteria declined and deinococci became the predominant group in the microflora, particularly at 20 degreesC, although at 30 degreesC the number of deinococci as well rapidly declined. The results suggest that the natural habitat of deinococci is an aerobic environment containing a slightly elevated saline content, soluble protein, and low sugar levels.
Assuntos
Indústria de Processamento de Alimentos , Cocos Gram-Positivos/isolamento & purificação , Cocos Gram-Positivos/efeitos da radiação , Ostreidae/microbiologia , Animais , Contagem de Colônia Microbiana , Meios de Cultura , Contaminação de Alimentos , Cocos Gram-Positivos/crescimento & desenvolvimento , Tolerância a RadiaçãoRESUMO
OBJECTIVE: To review the experience with adrenal surgery which was associated with significant morbidity and notable mortality in the past, although laparoscopic approach is beginning to be accepted as the procedure of choice. METHODS: The indications and results of adrenalectomy in 104 patients (36 men, 68 women) over the past 16 years were reviewed. Any potential improvement of surgical results over time was analyzed. RESULTS: Ninety-three patients (89%) had functional problems while malignancy was present in 11 patients (11%). Anterior approach was employed in 27 patients, posterior in 56, lateral in 10, and laparoscopic in 11. One patient required conversion from laparoscopic to anterior approach. No operative mortality was seen, but the morbidity occurred in 16.7%. Complication rate decreased significantly in this study period (1981-1990 versus 1991-1996, 22% versus 5%; P = 0.02). Laparoscopic adrenalectomy was successfully performed for 59% of the patients requiring adrenalectomy recently, compared to 68% of posterior adrenalectomy in the past. CONCLUSIONS: Adrenal surgery is a safe procedure, associated with acceptable morbidity, which has decreased over time. Laparoscopic adrenalectomy is becoming the preferred approach for the majority of patients requiring adrenalectomy.
Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia/métodos , Hiperfunção Adrenocortical/cirurgia , Laparoscopia , Adolescente , Adrenalectomia/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Feocromocitoma/cirurgiaRESUMO
Comprehensive neuropsychological batteries focus on the subtle cognitive deficits in dementia, but a brief screening instrument is also of immense practical value. As the clock-drawing test encompasses a number of cognitive domains frequently disturbed by the dementing process, it is considered to be a suitable screening instrument for the disorder. We documented the usefulness of a new scoring method of the clock-drawing test for screening of dementia in the elderly Chinese in Hong Kong. Fifty-three demented individuals and 53 healthy elderly controls were assessed. At a cutoff score of 3/4, the sensitivity and specificity of the clock-drawing test in screening of dementia was 83% and 79%. With a composite test of clock reading and clock setting, the positive predictive value of the clock face test was 98%. This new scoring method of clock-drawing proved to be a valid measure for screening of dementia. It is applicable in non-English speaking populations and should be a useful adjunct for quick screening assessment of dementia.
Assuntos
Demência/diagnóstico , Programas de Rastreamento , Testes Neuropsicológicos , Idoso , Análise de Variância , China/etnologia , Cognição/fisiologia , Demência/fisiopatologia , Escolaridade , Feminino , Hong Kong , Humanos , Idioma , Masculino , Valor Preditivo dos Testes , Sensibilidade e Especificidade , TempoRESUMO
Recent studies in the West have found that verbal fluency tests are useful in the detection of dementia. In this study, the Fuld Verbal Fluency Test (FVFT) was modified and tested for its usefulness as a screening instrument for differentiating demented from normal elderly Chinese in Hong Kong. Fifty-three normal and 56 demented subjects were administered the FVFT, the Cantonese version of the Mini-Mental State Examination (CMMSE), and the Chinese version of the Hamilton Depression Rating Scale. In addition to bearing significant correlation with the CMMSE, the verbal fluency scores for all semantic categories (animals, fruits, vegetables) were found to produce significant differentiation between the normal and demented groups. However, test-retest reliability for the individual verbal fluency scores was shown to be unsatisfactory, and a composite measure was recommended for use in future screening on the grounds of its enhanced reliability.
Assuntos
Demência/psicologia , Comportamento Verbal , Idoso , Idoso de 80 Anos ou mais , Demência/diagnóstico , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
This study examines the nature and extent of the relationship between stress levels and intentions to participate in a worksite smoking cessation program among male current smokers (n = 220) employed in an automobile manufacturing plant. A plantwide survey was conducted which measured job stress, nonjob stress, smoking behavior, and intent to participate. The results of polychotomous logistic regressions suggest that among the current smokers in this plant, job and nonjob stress were positively associated with workers' intentions to participate in a worksite smoking cessation program. Thus, contrary to the popular notion that stress diminishes the motivation to quit, employees under high levels of stress may be most receptive to educational interventions intended to persuade smokers to commit to quitting.