RESUMO
OBJECTIVES: Later-life cognitive impairment is an important health issue; however, little is known about the condition among diverse groups such as immigrants. This study aims to examine whether the healthy immigrant effect exists for verbal fluency, an indicator of cognitive functioning, among anglophone middle-aged and older adults in Canada. METHODS: Using from the baseline data of the Canadian Longitudinal Study on Aging (CLSA), multiple linear regression was employed to compare associations among immigrants (recent and long-term) and Canadian-born residents without dementia for two verbal fluency tests, the Controlled Oral Word Association Test (COWAT) and the Animal Fluency (AF) task. Covariates included socioeconomic, physical health, and dietary intake. RESULTS: Of 8,574 anglophone participants (85.7% Canada-born, 74.8% aged 45-65 years, 81.8% married, 81.9% with a post-secondary degree), long-term immigrants (settled in Canada >20 years) performed significantly better than Canadian-born residents for the COWAT (42.8 vs 40.9) but not the AF task (22.4 vs 22.4). Results of the multivariable adjusted regression analyses showed that long-term immigrants performed better than Canadian-born peers in both the COWAT (B=1.57, 95% CI: 0.80-2.34) and the AF test (B=0.57, 95% CI: 0.19-0.95), but this advantage was not observed among recent immigrants. Other factors associated with low verbal fluency performance included being single, socioeconomically disadvantaged, having hypertension, excess body fat, and consuming low amounts of pulses/nuts or fruit/vegetables. CONCLUSIONS: Long-term immigrants had higher verbal fluency test scores than their Canadian-born counterparts. Immigration status, social, health and nutritional factors are important considerations for possible intervention and prevention strategies for cognitive impairment.
Assuntos
Emigração e Imigração/estatística & dados numéricos , Estado Nutricional/fisiologia , Aprendizagem Verbal/fisiologia , Idoso , Envelhecimento , Canadá , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Tinnitus, head and ear noise, is due to maladaptive plastic changes in auditory and associated neural networks. Tinnitus has been traditionally managed through the use of sound to passively mask or facilitate habituation to tinnitus, a process that may take 6-12 months. NEW METHOD: A game-based perceptual training method, requiring localisation and selective attention to sounds, was developed and customised to the individual's tinnitus perception. Eight participants tested the games usability at home. RESULTS: Each participant successfully completed 30 min of training, for 20 days, along with daily psychoacoustic assessment of tinnitus pitch and loudness. The training period and intensity of training appears sufficient to reduce tinnitus handicap. COMPARISON WITH EXISTING METHOD(S): The training approach used may be a viable alternative to frequency discrimination based training for treating tinnitus (Hoare et al., 2014) and a useful tool in exploring learning mechanisms in the auditory system. CONCLUSIONS: Integration of tinnitus assessment with therapy in a game is feasible, and the method(s) warrant further investigation.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Psicoacústica , Zumbido/terapia , Jogos de Vídeo , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Zumbido/diagnóstico , Resultado do TratamentoRESUMO
We aimed to confirm the reliability of the Japanese version of the Aging Males' Symptoms rating scale (JPN-AMS) and its applicability in patients with testosterone deficiency syndrome (TDS)-like symptoms, comparing it for young, middle-aged and elderly Japanese men. The study included 93 patients with TDS-like symptoms, 39 men younger than 30 years old, and 125 normal men 40 years old and older, who agreed to respond to a self-administered questionnaire using the JPN-AMS. Testing-retesting was done to confirm the reliability of the questionnaire, with a 2-week interval between tests. The total AMS score and three domain scores were clearly higher in patients with TDS-like symptoms than in young men and in normal males, respectively. The test-retest analysis showed good reliability and internal consistency for the JPN-AMS. The JPN-AMS can be reliably used for measuring health-related quality of life of aging Japanese males.
Assuntos
Envelhecimento/fisiologia , Indicadores Básicos de Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Testosterona/deficiência , Testosterona/metabolismoRESUMO
We describe the preoperative application of limited cone beam computerized tomography (CT) using a Dental three-dimensional (3D)-CT as an assessment tool before minor oral surgery. The Dental 3D-CT provided 42.7 mm-high and 30 mm-wide rectangular solid images. This size covered the height of the mandible with standing teeth. Dental 3D-CT clearly demonstrated lesions in the maxillary and mandibular bone. Resorption of the bone due to disease expansion was depicted more clearly on the Dental 3D-CT than on conventional radiographs. Information about lesion location and the relationship between the lesions and their adjacent anatomical structures, such as the mandibular canal and maxillary antrum, was useful for minor oral surgery. Due to its high resolution and low radiation dose, Dental 3D-CT was useful for preoperative examination prior to minor oral surgery.
Assuntos
Doenças Maxilomandibulares/diagnóstico por imagem , Procedimentos Cirúrgicos Bucais/métodos , Radiografia Dentária/métodos , Cirurgia Assistida por Computador , Adulto , Feminino , Humanos , Arcada Osseodentária/diagnóstico por imagem , Doenças Maxilomandibulares/cirurgia , Neoplasias Maxilomandibulares/diagnóstico por imagem , Neoplasias Maxilomandibulares/cirurgia , Masculino , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Procedimentos Cirúrgicos Bucais/instrumentação , Planejamento de Assistência ao Paciente , Cuidados Pré-Operatórios , Tomografia Computadorizada por Raios X/métodos , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgiaRESUMO
Massive amounts of quantitative data are being obtained by toxicity tests with time. These data sometimes include the data with a different distribution pattern or with different numbers of animals in each group. The tree-type algorithm has long been used commonly to promptly analyze the difference between the control group and dosage groups. In Japan, the decision tree has been used since 1982 with several modifications of the initial procedure. Recently, the method has been revised to have a high power. The changes have been made in two directions; one is a sophisticated method and the other is a simplified method. In this paper, the historical transition of the decision tree is described and the future of the decision tree forecasted.
Assuntos
Bioensaio/estatística & dados numéricos , Interpretação Estatística de Dados , Árvores de Decisões , Toxicologia/estatística & dados numéricos , Animais , Japão , RatosRESUMO
Home care of patients is mainly performed by visiting nurses. To adequately perform the care, many type of knowledge are needed. Especially psychological approaches can minimize the pain to the patients and their family and shortening its duration and raising the efficacy of the treatment. Cooperation with clinical psychologists can be effective. We present three cases who were difficult to help by nurses alone Thus, Nurses provided in cooperation with the psychologists. First case was a 27-year-old man with cerebral palsy. Second case was a 55-year-old man with lung cancer, terminal stage. Third case was a 60-year-old man with amyotrophic lateral sclepsis. Through these different cases, we recognized the difficulties of medical care at home and also the importance of cooperation with psychologist. With the aging of society, the amount and type of home care needed will increase. Under long term insurance, the various type of knowledge, especially, psychological approaches is important. At the same time, training and education in this field for visiting nurses is required.
Assuntos
Enfermagem em Saúde Comunitária , Serviços de Assistência Domiciliar/estatística & dados numéricos , Seguro de Assistência de Longo Prazo , Psicologia , Enfermagem em Saúde Comunitária/educação , Comportamento Cooperativo , Feminino , Humanos , MasculinoRESUMO
The Federal Food, Drug, and Cosmetic Act and related regulations (21 U.S.C. 301 et seq.) give FDA staff the legal authority and responsibility to review the safety and effectiveness of drugs and biological products (including products used in cancer treatment), from preclinical testing through all phases of clinical research and marketing. FDA review activities in the oncology arena can be divided into five major categories: (1) initial review of investigational new drug (IND) applications; (2) ongoing review of premarketing research (including new research protocols submitted to existing INDs and IND safety reports describing adverse events with the new drug); (3) discussions with commercial sponsors regarding their clinical development plans, including the design and conduct of key studies that are intended to support initial marketing approval for a new product or to support the addition of new indications to the prescribing information for currently marketed products; (4) review of submitted new drug applications (NDAs) or biological licensing applications (BLAs); and (5) continuing review of the safety and effectiveness of marketed products. Through these review activities, FDA staff work to ensure that products approved for marketing for cancer treatment are effective and adequately safe for their intended uses and to ensure that the quality, effectiveness, and safety of products on the market are preserved or enhanced, so patients and physicians may use these products with confidence and with adequate safety. Because these review activities generally fall into a chronologic sequence, the following discussion parallels the development course of a typical new drug.
Assuntos
Antineoplásicos/normas , Antineoplásicos/uso terapêutico , Neoplasias/tratamento farmacológico , United States Food and Drug Administration , Humanos , Marketing de Serviços de Saúde/normas , Projetos de Pesquisa , Estados UnidosRESUMO
PURPOSE: The purpose of this study was to examine the factors involved in the low usage of home care services in Japan half a year after their enforcement. METHOD: Questionnaires were mailed to the 1,500 senior citizens residing in H city Osaka who were using the home care services covered by the long-term care insurance system. Of the 1,500, 888 responded (59.2%). RESULTS: Of the 888 respondents, 70.7% were women, with a mean age of 82.0 +/- 7.2 years; 33.2% were living alone and 19.3% were living with their spouse. The rate of use was higher than the national average. Use amount of money. Then, when yen 10,000-15,000 were exceeded that the number of users is halved. Of the service control factor, 40% were economical burden, 32% were no-necessary of service, 27% were feeling of resistance to staff and shortage of information, 7% were complicated proceduring and without service. The rate of use and significant relation were seen, "senior citizen only family, short-stay service, home helper service, day care service, and the senior is dementia".
Assuntos
Serviços de Assistência Domiciliar/estatística & dados numéricos , Seguro de Assistência de Longo Prazo/estatística & dados numéricos , Idoso , Custos e Análise de Custo , Feminino , Serviços de Assistência Domiciliar/economia , Humanos , Seguro de Assistência de Longo Prazo/economia , MasculinoRESUMO
The General Measure of the Functional Assessment of Cancer Therapy scale (FACT-G) was developed in an English-speaking culture (USA). To determine if FACT-G could be used in Japan, a cross-cultural validation was performed. The Japanese version was created through an iterative forward-backward translation sequence used throughout the FACT multi-lingual translation project. In evaluating psychometric testing, its construct validity was investigated by factor analysis and multi-trait scaling analysis. Clinical validity was estimated by known-groups comparison using stage, performance score (PS) and patient location, and validated longitudinally by PS. The FACT-G (version 3) was given to 180 patients with lung cancer. Analyses showed that the scales of Physical, Functional, Emotional Well-Being, and Relationship with Doctors were constructively valid in Japan. Japanese patients felt that familial relationships were different than those with friends and neighbors, indicating that the Social/Family Well-Being scale needed cultural adaptation. Two items concerning coping with illness and acceptance of illness did not load predictably onto their respective scales and were considered to be cross-culturally problematic. However, clinical validity demonstrated its sensitivity. Japanese version 4 has been improved to address the weakness in an attempt to become an instrument that is applicable across cultures.
Assuntos
Neoplasias/terapia , Qualidade de Vida , Perfil de Impacto da Doença , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Comparação Transcultural , Análise Fatorial , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Psicometria , Sensibilidade e EspecificidadeRESUMO
PURPOSE: To evaluate the long-term safety and efficacy, in a large series of patients, of polyacrylic intraocular lens implants 1 and 3 years after surgery, compared with polymethylmethacrylate intraocular lens implants. METHODS: This was a randomized, prospective study of 1,514 eyes of 1,202 patients that were examined for a 1-year follow-up study and 1,264 eyes of 990 patients that were examined for a 3-year follow-up study. All the patients were prospectively randomized to receive a polyacrylic or polymethylmethacrylate intraocular lens implant. A standardized surgical protocol was performed using a phacoemulsification technique and capsulorhexis. Any surgical complications were excluded, and all patients had standard postoperative medication and follow-up. Postoperative measurements included spectacle-corrected visual acuity, occurrence of postoperative sight-threatening or lens-related complications, and adverse reactions. Results were compared between the polyacrylic intraocular lens and polymethylmethacrylate intraocular lens groups. Results were also compared with standards for polymethylmethacrylate intraocular lens that were established by the US Food and Drug Administration and a previous study for silicone lens. RESULTS: The overall complete follow-up rates were 79.9% for 1-year follow-up and 69.5% for 3-year follow-up. At 1 year, the mean logarithm of the minimum angle of resolution (logMAR) of visual acuity was 0.037 +/- 0.150 and 0.042 +/- 0.154 in best case patients of the polyacrylic intraocular lens group and polymethylmethacrylate intraocular lens group, respectively. At 3 years, the mean logMAR visual acuity was 0.038 +/- 0.155 and 0.054 +/- 0.181 in best case patients in the polyacrylic intraocular lens group and polymethylmethacrylate intraocular lens group. There was no significant difference between groups at 1 and 3 years. At 1 year, 96.8% of best case patients in the polyacrylic intraocular lens group and 95.8% of those in the polymethylmethacrylate intraocular lens group achieved corrected visual acuity of 0.5 or better. At 3 years, 96.4% of best case patients in the polyacrylic intraocular lens group and 94.9% of those in the polymethylmethacrylate group achieved a corrected visual acuity of 0.5 or better; no significant difference was found at 1 and 3 years. The rate of sight-threatening complications was 1. 2% for the polyacrylic intraocular lens group of all patients and 1. 5% for the polymethylmethacrylate intraocular lens group at 1 year, and 1.6% for the polyacrylic intraocular lens group and 1.4% for the polymethylmethacrylate intraocular lens group at 3 years. No significant difference was found between the groups. The cumulative rate of Nd:YAG capsulotomy for the polyacrylic intraocular lens group (7.1%) was significantly lower than that for the polymethylmethacrylate intraocular lens group (38.1%) through 3 years (P <.0001). CONCLUSIONS: Polyacrylic intraocular lenses demonstrated safe and effective performance through long-term follow-up at a level equal to or better than polymethylmethacrylate intraocular lenses. Patients undergoing polyacrylic intraocular lens implantation achieved excellent postoperative visual acuity and experienced a low rate of postoperative complications, adverse reactions, and Nd:YAG capsulotomy. These long-term clinical results are an important outcome database for the ongoing use of this foldable optic material.
Assuntos
Resinas Acrílicas , Implante de Lente Intraocular , Lentes Intraoculares , Idoso , Idoso de 80 Anos ou mais , Materiais Biocompatíveis , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Facoemulsificação , Polimetil Metacrilato , Complicações Pós-Operatórias , Estudos Prospectivos , Segurança , Acuidade VisualRESUMO
Regarding the statistical analysis of the quantitative data obtained in control and dosage groups in toxicity studies, we tried to simplify the decision tree method. In a new decision tree presented in this article, one-way analysis of variance and Kruskal-Wallis nonparametric analysis of variance are excluded from the traditional decision tree: (1) Bartlett's test is used as a test for the equality of k variances: (2) Then, if the k sampled populations have equal variances (p > 0.05 by the Bartlett's test), Dunnett's multiple comparison test is performed: otherwise, Steel's test is used. This new method, which increases the power in some conditions, may serve as an alternative to the traditional decision tree method.
Assuntos
Árvores de Decisões , Testes de Toxicidade , Análise de Variância , Animais , Roedores , Estatística como AssuntoRESUMO
A novel method of quantitating cell migration has been proposed for the potential utilization of tissue engineered scaffolds. Applying Alt's conservation law to describe the motion of first passage ACL and MCL cells, we have developed a quantitative method to assess innate differences in the motility of cells from these two ligamentous tissues. In this study, first passage ACL and MCL cells were cultured from four mature New Zealand white rabbits. One side of the cell monolayer was scraped completely away to create a wound model. The cell moved into the cell-free area, and cell density profiles were analyzed at 6 h and 12 h. Values of the random motility coefficient (mu) were then estimated by curve fitting the 6 h and 12 h data to a mathematical model, derived from the conservation law of cell flux. During 6 h of incubation in medium supplemented with 1% FBS, MCL cells (mu(MCL) = 4.63 +/- 0.65 X 10(-6) mm(2)/sec) were significantly (p < 0.05) more mobile than ACL cells (mu(ACL) = 2.51 +/- 0.31 X 10(-6) mm(2)/sec). At 12 h, the MCL cells also appeared to move faster (mu(ACL) = 4.39 +/- 0.63 X 10(-6) mm(2)/sec, mu(MCL) = 6.59 +/- 1.47 X 10(-6) mm(2)/sec), but the difference was not statistically significant (p = 0.18). Exposure of the cells to growth factors PDGF-BB or bFGF for 6 h had no significant effect on the migration of the ACL and MCL cells. However, exposure of the ACL cells (p < 0.05) and the MCL cells (p = 0.19) to 1 ng/mL of PDGFBB for 12 h enhanced their migration. Incubation with a high concentration (100 ng/mL) of PDGF-BB or bFGF at concentrations tested (1 or 100 ng/mL) for 12 h, produced little or no migratory stimulation on these ligament cells. Our findings support the previous qualitative observations made by numerous investigators. The novel methodology developed in this study may provide a basis for tissue engineering, and the results may be applied to tissue reconstruction techniques of the knee ligaments.
Assuntos
Ligamento Cruzado Anterior/citologia , Movimento Celular , Ligamentos Colaterais/citologia , Animais , Ligamento Cruzado Anterior/efeitos dos fármacos , Ligamento Cruzado Anterior/fisiologia , Becaplermina , Engenharia Biomédica , Movimento Celular/efeitos dos fármacos , Células Cultivadas , Ligamentos Colaterais/efeitos dos fármacos , Ligamentos Colaterais/fisiologia , Fator 2 de Crescimento de Fibroblastos/farmacologia , Fator de Crescimento Derivado de Plaquetas/farmacologia , Proteínas Proto-Oncogênicas c-sis , Coelhos , Regeneração/efeitos dos fármacos , Cicatrização/efeitos dos fármacosRESUMO
Peripheral blood stem cell transplantation (PBSCT) has many advantages for patients because hematopoiesis and general condition return to normal more rapidly than they do following bone marrow transplantation. Thus, the authors hypothesize that the nutritional condition of patients also returns to normal more rapidly after PBSCT. The duration of insufficient nutrition was investigated in children undergoing PBSCT. The subjects of this study were 8 patients with malignant diseases. The factors measured were body weight, body fat, cholesterol, albumin, pre-albumin, and retinol-binding protein. These parameters were measured a day before transplantation, and then once a week for 4 weeks after transplantation. All parameters were recovered until day 28 from the lowest level in transplantation. In this study, all parameters returned to normal comparatively early. PBSCT causes little damage to patients' nutrition.
Assuntos
Transplante de Células-Tronco Hematopoéticas , Avaliação Nutricional , Adolescente , Animais , Peso Corporal , Criança , Pré-Escolar , Colesterol/sangue , Humanos , Leucemia/complicações , Leucemia/terapia , Linfoma/complicações , Linfoma/terapia , Proteínas de Ligação ao Retinol/metabolismo , Albumina Sérica/metabolismo , Fatores de TempoRESUMO
The role of tropisetron as an anti-emetic drug in the prevention of delayed nausea and vomiting remains unclear. Therefore, effectiveness of tropisetron in patients receiving cancer chemotherapy was evaluated by application of summary measures using a quality of life (QOL) questionnaire. The diary-type QOL self-rating questionnaire was constituted by seven scales. A double-blind randomized, multicentre study was performed in 33 hospitals. Quality of life was measured in 98 patients. Patients receiving cisplatin were randomized to group T (administration of tropisetron before and 4 days after cisplatin treatment) and group P (administration of tropisetron before cisplatin treatment and followed by placebo for 4 days). The rate of complete protection from delayed emesis in the groups T and P was 46.3 and 36.5%. All scales, except social wellbeing changed immediately in both groups and reached a nadir on days 2-3, after that returning to the control levels during 2 weeks after cisplatin treatment. Group T was significantly better than group P in physical wellbeing, mental wellbeing, functional wellbeing and global QOL scores summarized by area under the curve and Difmax (maximum differences of QOL scales' score from the best score throughout the entire period). These results indicate that continuous administration of tropisetron could contribute to preventing patient QOL influenced by cisplatin treatment, and the combined use of summary measures may be useful for the evaluation of QOL in cancer clinical trial.
Assuntos
Antieméticos/uso terapêutico , Antineoplásicos/efeitos adversos , Cisplatino/efeitos adversos , Indóis/uso terapêutico , Náusea/prevenção & controle , Qualidade de Vida , Vômito/prevenção & controle , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/etiologia , Inquéritos e Questionários , Tropizetrona , Vômito/etiologiaRESUMO
The Japanese Quality of Life Research Group has developed a general questionnaire suitable for assessing the Quality of Life (QOL) in patients undergoing chemotherapy. The questionnaire covers four major categories: (1) daily activities, (2) physical condition, (3) social activities, and (4) mental and psychological status. The State-Trait Anxiety Inventory (STAI), Self-Rating Depression Scale (SDS), and Performance Status (PS) were used as external measures of quality of life and for the validation of our tool. On the basis of two basic surveys and two studies we selected 22 questions from a larger set of items. Validity and reliability were verified for the final 22-question form. This questionnaire, named the QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD), can be used to detect changes in QOL over time. Its use as an additional outcome measure in Phase III chemotherapy trials should be encouraged.
Assuntos
Neoplasias/tratamento farmacológico , Neoplasias/psicologia , Qualidade de Vida , Inquéritos e Questionários/normas , Adulto , Antineoplásicos/uso terapêutico , Feminino , Humanos , Japão , Masculino , Psicometria , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The aim of this study was to confirm the validity and reliability of a new diary-type quality of life (QOL) self-rating questionnaire tailored for use by Japanese inpatients with lung cancer receiving chemotherapy. Two kinds of summary statistics were tested in QOL analysis. The questionnaire has a four-scale structure; physical, psychological, daily activity and global scales. Fifty-three patients were enrolled to test the reliability and validity. Summary statistics were assessed using indices of the area under the curve (AUC) and the maximum fluctuations of QOL scores (Dif max) in patients receiving cisplatin or carboplatin. The questionnaire had satisfactory reliability and validity. The physical, psychological and global scales scores changed to the worst levels after treatment, continuing for 1 week in the cisplatin group, whereas those of the carboplatin group began to worsen from day 3, but returned to prechemotherapy levels by day 9. The cisplatin group showed significant decrease of QOL compared with the carboplatin group in the AUC of psychological and two global scales, in the Dif max of psychological and linear analogue global scales. These results suggested that this questionnaire reflects differences in the influence of chemotherapy, and that AUC and Dif max may be useful indices for the analysis of QOL as measures to assess multidimensional QOL.
Assuntos
Antineoplásicos/uso terapêutico , Neoplasias Pulmonares/psicologia , Prontuários Médicos , Qualidade de Vida , Inquéritos e Questionários , Adulto , Idoso , Carboplatina/uso terapêutico , Cisplatino/uso terapêutico , Tratamento Farmacológico/psicologia , Feminino , Humanos , Japão , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
We assessed the regional cerebral blood flow (rCBF) in 8 patients with subcortical aphasia and 8 patients with subcortical infarction without aphasia using the N-isopropyl-P-[123I]-iodoamphetamine autoradiography (123I-IMP ARG) method. In this study, we evaluated vermis to left cortex ratio of CBF. In cases of Broca's aphasia (N = 2), CBF was lower in the posterior frontal regions including Broca's area, and more hypoperfused in the posterior frontal and in the posterior temporal regions, including Wernicke's area of total aphasia (N = 2). But, it was not significantly hypoperfused in those regions in the cases of Wernicke's (N = 2) and amnestic aphasia (N = 2). In the subcortical aphasia, global CBF in the left cerebral cortex was lower than that in the right cerebral cortex. However, in the subcortical infarction group without aphasia there was no difference between CBF in the left cerebral cortex and the right cerebral cortex. We conclude that hypoperfusion in the left cerebral cortex was greater than that in the right cerebral cortex and it was probably due to dysfunction of the left cerebral cortex when subcortical infarction occurred with aphasia. Though some types of aphasia were not relative to the dysfunction of the left cerebral cortex.
Assuntos
Afasia/etiologia , Afasia/fisiopatologia , Infarto Cerebral/complicações , Infarto Cerebral/fisiopatologia , Circulação Cerebrovascular/fisiologia , Idoso , Anfetaminas , Anomia/fisiopatologia , Afasia de Broca/fisiopatologia , Afasia de Wernicke/fisiopatologia , Feminino , Humanos , Radioisótopos do Iodo , Iofetamina , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo RegionalRESUMO
Eight hundred and sixty-two patients who visited the department of neuropsychiatry and who were prescribed benzodiazepine (BZ) hypnotics were investigated to evaluate the actual state of their use, in terms of age, gender, diagnostic categories according to ICD-9, duration of prescription and dose equivalent to diazepam prescribed. The frequency of prescriptions in subjects were surveyed using Kaplan-Meier survival analysis at every 3 months. Mean survival time to discontinuation was 8.5 months. A total of 60% of the subjects did not receive BZ hypnotics at the end of the third month, but 20% remained to be prescribed after 1 year. Moreover, 7.9% of the subjects were prescribed BZ hypnotics even after 3 years. The results indicated that 20% of patients who had started prescriptions for BZ hypnotics had the potential to induce dependence. The following variables were found in the long-term prescription: male patients; aged patients over 60; and affective psychoses (which mainly consisted of depression) including neurotic depression, in the present study. A low dose was considered to be associated with an ability to be free from BZ hypnotics in an early period.
Assuntos
Benzodiazepinas/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Assistência de Longa Duração/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Fatores Etários , Benzodiazepinas/efeitos adversos , Intervalos de Confiança , Grupos Diagnósticos Relacionados/estatística & dados numéricos , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Hipnóticos e Sedativos/efeitos adversos , Japão , Assistência de Longa Duração/métodos , Estudos Longitudinais , Masculino , Transtornos Neuróticos/complicações , Fatores de Risco , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Análise de SobrevidaRESUMO
Fatty acid metabolism has been reported to be impaired earlier than myocardial blood flow in left ventricular hypertrophic myocardium, e.g., in hypertrophic cardiomyopathy or hypertensive heart disease. The purpose of this study was to determine whether impaired fatty acid metabolism also occurs in right ventricular (RV) hypertrophy. The subjects consisted of 6 patients with chronic obstructive pulmonary disease, 4 with primary pulmonary hypertension, 2 each with refractory pulmonary tuberculosis, tricuspid insufficiency, pulmonary embolism, 1 each with atrial septal defect, ventricular septal defect (Eisenmenger complex), Ebstein anomaly, and endocardial defect, and 7 healthy controls. SPECT imaging with Tl-201 (Tl) and I-123 beta-methyliodophenyl pentadecanoic acid (BMIPP), and Tc-99m RBC first pass and gated blood pool scintigraphy were performed. Based on Tl planar images, the subjects were classified into 3 groups: 7 patients with no RV visualization (Group A), 11 with moderate RV visualization (Group B) and 9 with marked RV visualization (Group C). As a semi-quantitative evaluation by Tl myocardial SPECT, 3 regions in 3 representative short axial images were divided into 9 segments, each of which was graded from 0 to +3, and their sum was calculated as the RV score. The right ventricular ejection fraction (RVEF) and the left ventricular ejection fraction were obtained by Tc-99m RBC cardiac scintigraphy. The groups with marked visualization of the right ventricle had lower RVEF (p < 0.01), and there was a good correlation between the RVEF and the RV score with both Tl and BMIPP (Tl: r = -0.79, BMIPP: r = -0.70). Although a good correlation was demonstrated between the RV score with Tl and BMIPP in Groups A and B (r = 0.86, p < 0.001), in Group C, in which there was marked RV T1 visualization, the RV score with BMIPP was significantly smaller than with Tl (BMIPP vs. Tl: 11.5 +/- 3.7 vs. 16.4 +/- 3.8, p < 0.01). These findings suggest that impaired fatty acid metabolism may exist in severely hypertrophic right ventricle due to RV overload.