Prevalence and epidemiological trends in mortality due to COVID-19 in Saudi Arabia.

OBJECTIVES: This article describes the prevalence and epidemiological trends of COVID-19 mortality in the largest registry in the Kingdom of Saudi Arabia (KSA). STUDY DESIGN: A prospective epidemiological cohort study using data from all healthcare facilities in KSA collected between March 23, 2020, and April 30, 2022. Data on the number of daily deaths directly related to COVID-19 were gathered, analyzed, and reported. METHOD: Data analysis was carried out using national and regional crude case fatality rate and death per 100,000 population. Descriptive statistics using numbers and proportions were used to describe age, gender, nationality, and comorbidities. The mortality trend was plotted and compared with international figures. In addition, the most common comorbidities associated with mortality and the proportion of patients who received COVID-19 vaccine were reported. RESULTS: The total reported number of deaths between March 23, 2020, and April 30, 2022, was 9085. Crude case fatality rate was 1.21%, and death per 100,000 population was 25.38, which compared favorably to figures reported by several developed countries. The highest percentages of deaths were among individuals aged between 60 and 69 years, males (71%), and individuals with diabetes (60%). Only 2.8% of mortalities occur in patients who received COVID-19 vaccine. Diabetes, hypertension, and heart failure had the highest attributable risk of mortality among patients who died due to COVID-19. CONCLUSION: Case fatality rate and death per 100,000 population in KSA are among the lowest in the world due to multiple factors. Several comorbidities have been identified, namely, diabetes, hypertension, obesity, and cardiac arrhythmias.

Trends in health service use and potentially avoidable hospitalizations before Alzheimer's disease diagnosis: A matched, retrospective study of US Medicare beneficiaries.

INTRODUCTION: This study evaluates rates of all-cause emergency department visits, all-cause hospitalizations, potentially avoidable hospitalizations, and falls in 3 years preceding Alzheimer's disease (AD) diagnosis. METHODS: Patients with AD and controls with no cognitive impairment were identified from the Medicare claims data. Patients were required to be aged ≥ 65 years and have continuous Medicare enrollment for ≥4 years before the index date (AD cohort: first AD diagnosis in 2012-2014; controls: randomly selected medical claim). Outcomes for each preindex year were compared among propensity score-matched cohorts. RESULTS: Each year, before index, patients with AD were more likely to have all-cause emergency department visits, all-cause hospitalizations, potentially avoidable hospitalizations, and falls (P < .05 for all comparisons) than matched controls (N = 19,679 pairs). Increasing absolute and relative risks over time were observed for all outcomes. DISCUSSION: The study findings highlight the growing burden of illness before AD diagnosis and emphasize the need for timely recognition and management of patients with AD.

Age effect in generating mental images of buildings but not common objects.

Imagining a familiar environment is different from imagining an environmental map and clinical evidence demonstrated the existence of double dissociations in brain-damaged patients due to the contents of mental images. Here, we assessed a large sample of young and old participants by considering their ability to generate different kinds of mental images, namely, buildings or common objects. As buildings are environmental stimuli that have an important role in human navigation, we expected that elderly participants would have greater difficulty in generating images of buildings than common objects. We found that young and older participants differed in generating both buildings and common objects. For young participants there were no differences between buildings and common objects, but older participants found easier to generate common objects than buildings. Buildings are a special type of visual stimuli because in urban environments they are commonly used as landmarks for navigational purposes. Considering that topographical orientation is one of the abilities mostly affected in normal and pathological aging, the present data throw some light on the impaired processes underlying human navigation.

A dedicated system for topographical working memory: evidence from domain-specific interference tests.

In the present study, we used single- and dual-task conditions to investigate the nature of topographical working memory to better understand what type of task can hamper performance during navigation. During dual-task conditions, we considered four different sources of interference: motor (M), spatial motor (SM), verbal (i.e. articulatory suppression AS) and spatial environmental (SE). In order to assess the nature of topographical working memory, we used the Walking Corsi Test, asking the participants to perform two tasks simultaneously (M, SM, AS and SE). Our results showed that only spatial-environmental interference hampers the execution of a topographical working memory task, suggesting a task-domain-specific effect. We also found general gender differences in the topographical working memory capabilities: men were more proficient than women, regardless of the type of interferences. However, like men, women performed worse when a spatial-environmental interference was present.

Spatial location and pathway memory compared in the reaching vs. walking domains.

Spatial information processing is influenced by the space in which an individual acts and the nature of the stimulus. This distinction is also present in spatial memory, where stimuli are processed differently because of their nature and the space in which they are released. The aim of the present study was to compare college students' performance on spatial location and pathway memory tasks in two different domains (reaching and walking). Reaching space refers to the portion of space within "grasping distance" and walking space to that beyond arm's reach. Research results indicate that it is easier to remember a pathway in the walking than the reaching domain and to remember single spatial locations in the reaching domain. Women are more able to perform the task in the walking domain than the reaching domain and men perform equally well in both domains.

The trauma symptom inventory: Italian validation of an instrument for the assessment of post-traumatic symptoms.

AIM: The trauma symptom inventory (TSI; Briere, 1995) is a useful instrument for the assessment of post-traumatic and common trauma-related mental health symptoms. The purpose of the study was to validate the Italian version of the original TSI. METHODS: Participants from non-clinical (n = 285), clinical (n = 110) and post-traumatic (n = 30) samples completed the TSI as part of a battery that included self-report measures of trauma exposure [MMPI-2 PK scale and Impact of Event Scale-Revised (IES-R)] and of psychological symptoms [brief symptom inventory (BSI) and symptom questionnaire (SQ)]. TSI validity scales were compared with MMPI-2 validity scales in order to assess convergent validity. RESULTS: The TSI Italian version showed adequate internal consistency reliability and a good convergent validity. Discriminant function analysis indicates a classification accuracy of TSI scales of 90% for true-positive and 91.4% for true-negative post-traumatic stress disorder (PTSD) cases. A revised three-factor structural model, which demonstrated an adequate and the best fit for the data, was proposed. CONCLUSIONS: The study extended the generalization and validity of TSI and provided some suggestions for eventually revisiting factorial structure of the questionnaire.

Familiarity and environmental representations of a city: a self-report study.

"Sense of direction" is usually assessed by self-report. Several internal factors contribute to proficiency in navigation: spatial cognitive style, respondent's sex, and familiarity with the environment; however, questionnaires assessing sense of direction do not include all these factors. In a recent study, Nori and Piccardi reported that environmental familiarity was crucial for topographical orientation. Regardless of a person's spatial cognitive style (i.e., landmark, route, or survey), the greater their familiarity with the environment, the better their performance. In this study, a questionnaire was used, the Familiarity and Spatial Cognitive Style Scale, to measure 208 women's sense of direction and knowledge of their city of residence. Analysis showed that Spatial Cognitive Style predicted sense of direction but not town knowledge. By contrast, familiarity played a crucial role in both areas, confirming the importance of having a tool to assess this factor.

Vividness in judgements of guilt.

This study investigated the vividness variable in legal decision-making. It was hypothesised that different verdicts regarding the same legal case can be obtained by simply varying the vividness of phrases, without changing any probative element. 53 participants read Original (26) or Vivid (27) versions of testimonies to a homicide case, then made a decision as to the defendant's guilt. Results support the hypothesis: participants' judgements significantly differ between the two conditions; that is, participants who read the Original version consider the homicide as unintentional while participants who read the Vivid one are not able to choose between intentional or unintentional homicide. Therefore we can infer that vividness influenced the process by which guilt is attributed.

Seroprevalence of hepatitis a antibodies in a group of normal and Down syndrome children in Porto Alegre, southern Brazil.

The high incidence of Hepatitis A and B in institutionalized patients with Down Syndrome (DS) is not fully understood. Under poor hygienic conditions, immunological alterations might predispose individuals to these infections. Sixty three DS children between 1 and 12 years old living at home with their families were examined for anti-HAV and compared to age-matched controls (64 healthy children). This cross-sectional study was carried out from May 1999 to April 2000 at the Hospital de Clínicas of Porto Alegre, southern Brazil. Groups were compared in terms of age, sex, skin color, and family income (> R$ 500 and < R $ 500/month) by the chi-square test, with Yates' correction and for the prevalence of anti-HAV (Fisher's exact test). In the DS group (n=63), the mean age was 4.4 +/- 3.3 years, 94% of the patients were white and 51% were female. Family income was < or = R$ 500/month in 40 cases (63%). In the control group (n=64), the mean age was 4.8 +/- 2.7 years, 81% of the patients were white and 56% were female. Family income was < or = R$ 500 in 20 patients (31%). DS children's families had a significantly lower income (P<0.0005). In the DS group there were 6 positive (9.5%) anti-HAV cases, and all came from low-income families (less than R$ 500/ month). In the control group, 3 cases (4.7%) were positive for anti-HAV (two were from a low-income family and one was from a higher income family). These differences were not significant. Our data indicate that Hepatitis A is not a special risk for mentally retarded DS outpatients, even in a developing country like Brazil.

Seroprevalence of hepatitis A antibodies in a group of normal and Down Syndrome children in Porto Alegre, Southern Brazil

The high incidence of Hepatitis A and B in institutionalized patients with Down Syndrome (DS) is not fully understood. Under poor hygienic conditions, immunological alterations might predispose individuals to these infections. Sixty three DS children between 1 and 12 years old living at home with their families were examined for anti-HAV and compared to age-matched controls (64 healthy children). This cross-sectional study was carried out from May, 1999, to April, 2000, at the Hospital de Clínicas of Porto Alegre, southern Brazil. Groups were compared in terms of age, sex, skin color, and family income (> R$ 500 and < R$ 500/ month) by the chi-square test, with Yates' correction and for the prevalence of anti-HAV (Fisher's exact test). In the DS group (n=63), the mean age was 4.4 ± 3.3 years, 94 percent of the patients were white and 51 percent were female. Family income was <= R$ 500/month in 40 cases (63 percent). In the control group (n=64), the mean age was 4.8 ± 2.7 years, 81 percent of the patients were white and 56 percent were female. Family income was <= R$ 500 in 20 patients (31 percent). DS children's families had a significantly lower income (P<0.0005). In the DS group there were 6 positive (9.5 percent) anti-HAV cases, and all came from low-income families (less than R$ 500/ month). In the control group, 3 cases (4.7 percent) were positive for anti-HAV (two were from a low-income family and one was from a higher income family). These differences were not significant. Our data indicate that Hepatitis A is not a special risk for mentally retarded DS outpatients, even in a developing country like Brazil

The influence of 17 beta-oestradiol on K+ currents in smooth muscle cells isolated from immature rat uterus.

Potassium currents in cells isolated from myometrium of immature (23-26 days after birth) rats were measured by whole-cell patch clamp to analyse the effects of gonadal steroids. Predominantly outward K+ currents with an early transient component were recorded in response to depolarizing pulses from a holding potential of -90 mV. The transient current, which was rarely present in adult myometrial cells, was inactivated by holding the membrane potential at -40 mV and attenuated by 1 mM 4-aminopyridine. Under these conditions a second sustained outward current was apparent. Administration of 17 beta-oestradiol to the immature rat before isolation of the myometrial cells reduced the probability of occurrence of the transient currents from 78.6% of cells (n = 33) to 29.8% (n = 14). Progesterone had only a slight effect. The kinetics of the transient currents were differently influenced by the two steroids. Cells isolated from animals previously given 17 beta-oestradiol showed transient outward currents with significantly shorter time constants of decay than those for control cells. Conversely, progesterone caused the time constants to be increased. We conclude that the gonadal steroids exert an influence on the expression of different populations of ionic channels in isolated cells of the immature rat uterus. These channels may regulate the excitability and contractility of the uterus in vivo.

Expression of different potassium channels in cells isolated from human myometrium and leiomyomas.

OBJECTIVE: Electrophysiologic characteristics of human myometrial and leiomyomatous cells isolated in culture were investigated. Both types of cell were shown to be smooth muscle cells by immunofluorescence. STUDY DESIGN: Voltage-activated potassium currents were recorded by whole-cell patch-clamp techniques and analyzed for differences in expression, voltage-dependence, kinetics, and inactivation. RESULTS: Depolarizing-voltage steps from -90 mV to +30 mV elicited two types of noninactivating outward currents that differed in their kinetics in 83% (n = 36) of normal cells in culture for 3 to 5 days; 6% responded with fast (3.5 milliseconds) outward inactivating currents; 11% in culture for 1 day responded only with long-lasting inactivating currents (33.2 +/- 7.2 milliseconds). Cells isolated from leiomyomas responded preferentially (65%, n = 31) with fast (3.3 +/- 0.1 milliseconds) outward inactivating currents; 35% responded with noninactivating outward currents similar to those from normal cells. CONCLUSION: Different potassium channel currents, noninactivating and inactivating, are predominantly expressed in cells isolated from human myometrium and leiomyomas, respectively.