Rehab Centers: Traumatic Injury and Multiple Sclerosis: A Systematic Review and Meta-Analysis.

Traumatic Injury and Multiple Sclerosis: A Systematic Review and Meta-Analysis.

Filed under: Rehab Centers

Can J Neurol Sci. 2013 Mar 1; 40(2): 168-176
Warren SA, Olivo SA, Contreras JF, Turpin KV, Gross DP, Carroll LJ, Warren KG

A systematic review/meta-analysis of literature addressing a possible association between traumatic injury and onset of multiple sclerosis was conducted. Medline, Embase, Cochrane DSR, Ovid HealthStar, CINAHL, ISI Web of Science and Scopus were searched for analytical studies from 1950 to 2011. Two investigators independently reviewed articles for inclusion, assessing their quality using the Newcastle-Ottawa Scale. Of the 13 case-control studies included, 8 were moderate quality and 5 low; of the 3 cohort studies 2 were high and 1 moderate. Meta-analysis including moderate and low quality case-control studies produced a modest but significant odds ratio: 1.41 (95% confidence interval: 1.03, 1.93). However, when low quality studies were excluded, the resulting odds ratio was non-significant. Cohort studies produced a non-significant standardized incidence ratio of 1.00 (95% confidence interval: 0.86, 1.16). These findings support the conclusion that there is no association between traumatic injury and multiple sclerosis onset; more high quality cohort studies would help to confirm this observation.
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Mild Encephalopathy With Splenial Lesion and Parainfluenza Virus Infection.

Filed under: Rehab Centers

Pediatr Neurol. 2013 Mar; 48(3): 252-254
Abenhaim Halpern L, Agyeman P, Steinlin M, El-Koussy M, Grunt S

Mild encephalopathy with reversible splenial lesions has mainly been associated with influenza A and B virus infection. Patients present with neurologic symptoms 1 to 3 days after a prodromal illness and recover completely within a few days. Magnetic resonance imaging typically shows reversible lesions with reduced diffusion in the corpus callosum, predominantly in the splenium. We report on a 5-year old Caucasian boy who was referred with recurrent seizures and decreased level of consciousness after a 2-day prodromal fever and cough. Magnetic resonance imaging showed cytotoxic edema of the entire corpus callosum and the adjacent periventricular white matter with diffusion restriction and faint T(2)-hyperintensity. Parainfluenza virus type 1-3 infection was documented by direct immunofluorescence in the initial nasopharyngeal swab, but polymerase chain reaction for parainfluenza virus type 1-4 in the cerebrospinal fluid remained negative. This is-to our knowledge-the first description of mild encephalopathy with reversible splenial lesions in association with parainfluenza virus infection. The pathogenesis of mild encephalopathy with reversible splenial lesions, however, still remains unclear, and further studies investigating detailed mechanisms that lead to the typical brain lesions are warranted.
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Illness Uncertainty and Quality of Life of Patients with Small Renal Tumors Undergoing Watchful Waiting: A 2-year Prospective Study.

Filed under: Rehab Centers

Eur Urol. 2013 Feb 9;
Parker PA, Alba F, Fellman B, Urbauer DL, Li Y, Karam JA, Tannir N, Jonasch E, Wood CG, Matin SF

BACKGROUND: Few studies have examined factors associated with the quality of life (QOL) of patients with renal tumors. Illness uncertainty may influence QOL. OBJECTIVE: To prospectively examine the influence of uncertainty on general and cancer-specific QOL and distress in patients undergoing watchful waiting (WW) for a renal mass. DESIGN, SETTING, AND PARTICIPANTS: In 2006-2010, 264 patients were enrolled in a prospective WW registry. The decision for WW was based on patient, tumor, and renal function characteristics at the discretion of the urologist and medical oncologist in the context of the physician-patient interaction. Participants had suspected clinical stage T1-T2 disease, were aged ?18 yr, and spoke and read English. The first 100 patients enrolled in the registry participated in this study. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Patients completed questionnaires on demographics, illness uncertainty (Mishel Uncertainty in Illness Scale), general QOL (Medical Outcomes Study 36-item short-form survey), cancer-specific QOL (Cancer Rehabilitation Evaluation System-Short Form), and distress (Impact of Events Scale) at enrollment and at 6, 12, and 24 mo. Age, gender, ethnicity, tumor size, estimated glomerular filtration rate, comorbidities, and assessment time point were controlled for in the models. RESULTS AND LIMITATIONS: Among the sample, 27 patients had biopsies, and 17 patients had proven renal cell carcinoma. Growth rate was an average of 0.17cm/yr (standard deviation: 0.35). Mean age was 72.5 yr, 55% of the patients were male, and 84% of the patients were Caucasian. Greater illness uncertainty was associated with poorer general QOL scores in the physical domain (p=0.008); worse cancer-related QOL in physical (p=0.001), psychosocial (p<0.001), and medical (p=0.034) domains; and higher distress (p<0.001). CONCLUSIONS: This study is among the first to prospectively examine the QOL of patients with renal tumors undergoing WW and the psychosocial factors that influence QOL. Illness uncertainty predicted general QOL, cancer-specific QOL, and distress. These factors could be targeted in psychosocial interventions to improve the QOL of patients on WW. HubMed – rehab


The influence of sex on cognitive insight and neurocognitive functioning in schizophrenia.

Filed under: Rehab Centers

Prog Neuropsychopharmacol Biol Psychiatry. 2013 Feb 15;
Kao YC, Liu YP, Lien YJ, Lin SJ, Lu CW, Wang TS, Loh CH

Both impaired insight and cognitive deficits in schizophrenia are core features of this disorder. Previous studies have demonstrated the complex relationships between neurocognition and cognitive insight, as well as the contribution of neurocognition in explaining cognitive insight. However, there is lack of research regarding the influences of sex on the relation of neurocognition and cognitive insight. The present study sought to elucidate sex differences in cognitive insight and neurocognition in schizophrenia. Seventy and three outpatients (male=39) with DSM-IV diagnosis of schizophrenia or schizoaffective disorder were enrolled in the cross-sectional study. Participants were assessed with cognitive insight using the Beck Cognitive Insight Scale, executive functions using the Wisconsin Card Sorting Test, sustained attention using the Conner’s Continuous Performance Test (Second Edition), and intelligence using the Wechsler Adult Intelligence Scale-Third version, respectively. Sex differences in demographic and clinical variables were small; nevertheless, female patients had significantly later age of illness onset and higher levels of formal education than males (p<0.05). Poor cognitive insight was attributed to impairment in performance of executive function and sustained attention. Results from hierarchical regression analyses indicated sex as a moderator only in the association between cognitive insight and executive function. Our findings support an association between poor cognitive insight and neurocognitive impairment in outpatients with schizophrenia and suggest that the relationship may be sex-specific. This study highlights potential targets for effective intervention and rehabilitation in improving patients' insight toward mental illness. HubMed – rehab



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