Prevalence of cognitive dysfunction and hypothyroidism in an elderly community population

Extracranial metastasis of cerebral glioblastoma is rarely seen. Craniotomy and diversionary shunt are widely accepted causes of dissemination. Prognosis is poor but new therapeutic modalities may improve the survival and lessen the patient's symptoms. It is also important to diagnose extracranial metastasis because of possible response to treatment and fine-needle aspiration cytology can then be helpful. Two cases of extracranial metastases of glioblastoma multiforme diagnosed by fine-needle aspiration cytology are reported and a review of the literature is presented.     

Infant attention in relation to intellectual abilities in childhood.

Infant attention was observed at term and 4 mo of age in 93 preterm infants who were tested with the Wechsler Intelligence Scale for Children—Revised (WISC—R) at 8 yrs of age. Results show that for the term measure, total fixation time on the first 1-min trial to a repeated 2 by 2 checkerboard was negatively related to the childhood intelligence assessments for the entire sample and for the subset of Ss (n?=?61) from English-speaking families. For the 4-mo measure, the percentage of decrement in 1st fixation time over 1 min of repeated presentations of a 24 by 24 checkerboard was positively correlated with IQ scores for the English-speaking subsample. It is concluded that preterm infants who continued to fixate an unchanging stimulus for protracted periods of time were less intellectually able in childhood. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change in sex ratio of a Drosophila population in relation to population size

Changes in sex ratio with population size fluctuations were studied in natural and cage populations of Drosophila. It was shown that the proportion of females decreased with an increase in population size both in natural and laboratory populations. If laboratory populations were maintained on a poor diet, this effect was absent. The amplitude of number fluctuation was shown to be higher in males than in females. The possible role of density-dependent selection on sex in the control of population size dynamics is discussed.     

Correlates of competence in a child psychiatric population.

This study examined the relation between individual and composite measures of child competence with family background and adult ratings of psychopathology. A battery of psychological tests, generally considered to reflect competent functioning, was administered to 180 children, aged 6–12 years, who were consecutively referred to a psychiatric outpatient clinic. Generally, children who scored high on a composite competence index were rated by parents and teachers as showing fewer problems, which is consistent with observations in nonclinical samples. Moreover, analysis of the composite competence index supported the view that children with even a moderate degree of competence have an advantage. Two findings of this study differed from those observed in nonclinical samples. First, a composite measure of child competence was more likely than single measures to be related to parent and teacher ratings of competence and problems. Second, girls were generally less competent than boys. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of suicidal behavior in a juvenile detention population

The present study identifies the correlates of current suicidal ideation and past suicide attempt among 555 adolescents in a county juvenile detention center. Suicidal behavior in delinquent boys was generally associated with depression and decreased social connection, whereas suicidal behavior in delinquent girls was associated with impulsivity and instability. Current ideation was most significantly associated with current depression. In multivariate analyses, past attempts were associated with suicidal ideation and ineffective coping for males, with major life events and impulsivity for females, and with not residing with at least one biological parent prior to detention for both males and females.     

Peripheral somatic nerve function in relation to glucose tolerance in an elderly Caucasian population: the Hoorn study

Only sparse and contradictory data are available on peripheral somatic nerve function in relation to the total range of glucose tolerance. A random sample (n = 708) of people, stratified by age, sex, and glucose tolerance, from a Caucasian population aged 50 to 74 years was invited to undergo an examination including measures of large-fibre nerve function (ankle and knee reflexes, vibration sense, vibratory perception threshold (VPT) at the foot) and one measure of small-fibre function (thermal discrimination threshold (TDT) at the foot). A total of 267 subjects with a normal glucose tolerance (NGT), 167 with impaired glucose tolerance (IGT), 90 with newly diagnosed diabetes mellitus (NDM), and 73 with previously known diabetes (KDM) were included. KDM was associated with the highest prevalence of large-fibre nerve dysfunction. Within the range from NGT to NDM, most large-fibre function measures showed a decline with decreasing glucose tolerance. The TDT showed a decrease with an increase in fasting and post-load insulin levels (p < 0.05). We conclude that glucose intolerance is associated with impaired peripheral large-fibre nerve function, an association which seems to apply even in the non-diabetic range. Higher insulin levels were associated with a better small-fibre nerve function.     

Sodium excretion in relation to calcium and hydroxyproline excretion in a healthy Japanese population

To evaluate whether habitual excess sodium intake is a significant risk factor for calcium loss, we studied the relation between calcium excretion and sodium excretion in 410 male and 476 female Japanese aged 20-79 y. They were apparently healthy, free-living, and consuming diets of their own choosing. We divided the subjects into two groups: 20-49 y olds and 50-79 y olds. In each group, we observed significant positive correlation between daily calcium excretion and daily sodium excretion in both sexes. Multivariate analyses revealed that in each age group the relation was still significant after sex, age, body weight, and protein, calcium, and phosphorus intakes were adjusted for. The increases in urinary calcium excretion were estimated to be approximately 0.6 and 1.0 mmol for a 100-mmol increment in urinary sodium excretion for the 20-49 y olds and 50-79-y olds, respectively. We also observed significant positive correlations between daily hydroxyproline excretion and daily sodium excretion in both sexes for both age groups. The relation was still significant after sex, age, body weight, and protein intake from meat and fish were adjusted for. The results suggest that individuals with high sodium intake may lose more calcium in their urine than those with low sodium intake.     

Correlates and changes over time in drug and alcohol use within a barrio population

Extent and determinants of use of alcohol, marijuana, inhalants, and PCP were explored in a group of 339 Mexican American youths from the East Los Angeles Housing projects. Results from this study were compared to those from a similar survey carried out in the same area 2 years ago. Use of inhalants has declined markedly compared with prevalence reported in the previous report. However, use of alcohol and marijuana have increased across all age and sex cohorts. Prevalence of PCP use, explored for the first time in this report, was shown to be extremely high. Use of all drugs was generally predicted by age, sex, and number of peers reporting use. Self-concept factors, especially one's self-evaluation with respect to others, were also significant predictors to use of marijuana, inhalants, and PCP. However, alcohol use was not related to any self-concept factors. Language (Spanish-English) used both in the home and with peers was related to use of all substances studied. Limitations in the generalization of this study as a result of sampling problems are discussed.     

Autonomic nervous system dysfunction in elderly hypertensive patients with abnormal diurnal blood pressure variation: relation to silent cerebrovascular disease

To investigate the relationships among diurnal blood pressure (BP) variations and autonomic nervous system dysfunction, we assessed heart rate variability (HRV) using power spectral analysis of the 24-hour RR interval in 51 asymptomatic elderly hypertensive patients with various patterns of nocturnal BP fall. The extreme-dippers with marked nocturnal BP fall (n=16) had lower asleep low-frequency power (LF)/high-frequency power (HF) ratios (a relative index of sympathetic nervous system activity), while the nondippers without nocturnal BP fall (n=18) had lower awake LF/HF ratios and asleep/awake ratio for HF (an index of parasympathetic nervous activity), when compared with dippers with appropriate nocturnal BP fall (n=17). The incidence of multiple lacunar infarction detected by brain magnetic resonance imaging was 56% in the extreme-dippers and 38% in the nondippers, and both were markedly higher than that (6.3%) in the dippers (both P<.01). There was no significant relationship between the BP level and any HRV parameter for either the daytime or nighttime period. The asleep/awake ratio for systolic BP was significantly correlated with the asleep/awake ratio for HF (r= -.363, P<.01) and with the asleep/awake ratio for the LF/HF ratio (r=.540, P<.001), regardless of whether multiple lacunar infarction was present. In conclusion, the autonomic nervous system activity is not related to high BP level per se, rather its diurnal variation is more important as a determinant of the diurnal BP patterns, regardless of the presence or absence of cerebrovascular disease.     

Cognitive performance in a high-functioning community-dwelling elderly population

BACKGROUND: The purpose of this study was to examine the role of demographic factors as predictors of cognitive performance in a high-functioning, community-dwelling elderly population. METHODS: The study cohort consisted of 1,192 community-dwelling subjects, who were selected to represent the highest third of an elderly population with respect to physical and cognitive functioning. A neuropsychological battery, including 5 cognitive performance subtests (confrontation naming, delayed recognition span, similarities, figure-copying, and incidental delayed recall) was administered to the subjects in their homes. RESULTS: A summary measure of the 5 neuropsychological subtest scores, the total cognitive score, arrayed the study group across a broad range of difficulty, creating a near-normal distribution. Education, income, and race had statistically significant associations with the total score and the individual subtests. The effect of education was the most striking finding, explaining 30% of the variance in the total score. Education was most strongly related to the abstraction (partial R2 = .11) subtest, and least related to the memory subtests, delayed recognition (R2 = .02) and delayed recall (R2 = .01). CONCLUSIONS: Demographic factors are important predictors of cognitive performance in this high-functioning cohort. Education had the strongest influence on overall cognitive performance, and particularly notable associations with subtests that depended upon the use of previously learned materials. Longitudinal follow-up, now underway, will help to determine whether high levels of education help to maintain cognitive performance with age.     

Sex ratio adjustment in relation to paternal attractiveness in a wild bird population

When the relative fitness of sons and daughters differs, sex-allocation theory predicts that it would be adaptive for individuals to adjust their investment in different sexes of offspring. Sex ratio adjustment by females in response to the sexual attractiveness of their mate would be an example of this. In vertebrates the existence of this form of sex ratio adjustment is controversial and may be confounded with sex-biased mortality, particularly in sexually size-dimorphic species. Here we use PCR amplification of a conserved W-chromosome-linked gene to show that the sex ratio within broods of a natural population of sexually size-monomorphic collared flycatchers Ficedula albicollis is related to the size of their father's forehead patch, a heritable secondary sexual character implicated in female choice. Experimental manipulations of paternal investment, which influence the size of his character in future breeding attempts, result in corresponding changes in the sex ratio of offspring born to males in those breeding attempts. In contrast, manipulations of maternal investment have no effect on future sex ratios, and there is no relationship between variables predicting the reproductive value of the brood and nestling sex ratio. Analysis of recruitment of offspring reveals similar patterns of sex ratio bias. The results suggest that female collared flycatchers be able to adjust the sex ratio of eggs ovulated in response to the phenotype of their mate. This finding is most consistent with "genetic quality" models of sexual selection.     

Suicide in a spinal cord injured population: its relation to functional status

OBJECTIVE: To determine the relation between functional status and risk of suicide among individuals with spinal cord injury (SCI). DESIGN: A follow-up study of all individuals who survived a traumatic SCI during the period from 1953 through 1990. SETTING: An SCI center in eastern Denmark. SUBJECTS: A total of 888 individuals with SCI, including 236 who died, 23 of whom committed suicide. MAIN OUTCOME MEASURES: Standardized Mortality Ratios (SMRs) of suicides among individuals with SCI. RESULTS: A 100% follow-up was established January 1, 1993. The total suicide rate among individuals with SCI was nearly five times higher than expected in the general population and lower for men than for women. The suicide rate doubled from an early inclusion period (1953-1971) to a later period (1972-1990). An unexpected finding was that the suicide rate in the group of marginally disabled persons was nearly twice as high as the group of functionally complete tetraplegic individuals. CONCLUSION: Given the high frequency of suicide, there is a need for increased awareness by rehabilitation staff and general practitioners regarding depression and psychological adjustment difficulties. Such conditions should be given special attention during rehabilitation and follow-up, especially among women with SCI and the marginally disabled.     

The elderly in nursing homes: a special population

The ear-xiphisternum distance (EXD, the distance from the low edge of the ear to the xiphisternal basis in supine position) was used as a reference value for esophageal catheter insertion. ECGs recorded in the esophagus with bipolar electrocardiography using standard limb lead (ESLL) and conventional unipolar lead (ECUL) were compared. 112 patients with sinus rhythm and 76 patients during paroxysmal supraventricular tachycardia (PSVT) whose P-wave and QRS complex did not overlap were studied. The results suggested that in sinus rhythm the amplitude of the P-wave in ESLL was larger and the T-wave was smaller than in ECUL. During PSVT, the P-wave was much clear and higher in each lead of ESLL than that in ECUL. The ideal range of esophageal ECG recording was situated between the end of EXD and 6.5 cm proximal to it.     

Exercise and oxygen inhalation in relation to prognosis of chronic obstructive pulmonary disease

We examined the relationship between prognosis and arterial blood gases during exercise and 100 percent oxygen inhalation in 54 patients randomly selected from 119 background patients with chronic obstructive pulmonary disease (COPD). Light exercise was performed and 100 percent oxygen was inhaled during clinically stable stages. By four years after these tests, 19/54 patients had died from respiratory failure. All subjects had similar physical and clinical features. Survivors had significantly higher PaO2 during air breathing than nonsurvivors; in nonsurvivors, FEV1 and MVV were significantly lower, and heart rate and RV/TLC were significantly higher. Exercise PaO2 of nonsurvivors decreased by 6.7 mm Hg, whereas that of survivors did not change. The P(A--a)O2 did not change in survivors and nonsurvivors during exercise, but in survivors it was significantly smaller. Mean PaO2 after 100 percent oxygen was significantly lower, and PaCO2 was significantly higher in nonsurvivors than in survivors, and in nonsurvivors the increase in PaO2 during 100 percent oxygen correlated positively with the time between first admission and death. These results indicate that patients with combination of resting arterial hypoxemia, worsened hypoxemia during stepped-up exercise, and lesser degree of arterial oxygenation and increased PaCO2 during 100 percent oxygen inhalation may have a poor prognosis.     

Feelings of anxiety and associated variables in a very elderly population

The effect of octreotide on morning hyperglycemia and GH levels was evaluated in eight insulin-dependent diabetic patients. Octreotide (50 mcg) was administered through subcutaneous injections at different hours (20:00, 22:00 and 24:00 h) or through continuous subcutaneous night infusion from midnight to 08:00 at increasing rate between 03:00 and 08:00 h. After octreotide injection at midnight we noticed a sharp decrease of both glycemia (p < 0.005) and GH (p < 0.05) at 04:00 h, but not at 08:00 h. Only the night continuous infusion at increasing rate was able to reduce glycemia and GH at 04:00 and at 08:00 h (p < 0.001 and p < 0.01 respectively). The injections of octreotide at 20:00 and 22:00 h lowered GH values at 24:00 h (p < 0.01 and p < 0.05 vs insulin alone) but did not show any significant effect on blood glucose levels and GH at 04:00 and 08:00 h. In conclusion, only the continuous subcutaneous night infusion of octreotide at increasing rate during the last hours of the night was able to reduce simultaneously morning hyperglycemia and GH levels in insulin-dependent diabetic patients, whereas evening subcutaneous injections at different times did not show any appreciable effect.     

Steroid hormones, memory and mood in a healthy elderly population

Men (n = 31), women estrogen-users (n = 14), and women estrogen non-users (n = 41), whose average age was 72.1 +/- 5.6 years, were tested with a battery of psychological tests measuring verbal memory, visual memory, concentration and attention, language fluency and semantic memory, and mood. Plasma levels of testosterone (T), estradiol (E2), cortisol (CRT) and dehydroepiandrosterone-sulfate (DHEAS) were assessed by radioimmunoassay. The ratio of DHEAS to CRT was calculated to determine it's relationship to memory functioning. The men had higher T and DHEAS levels than both groups of women. Women estrogen-users had higher E2 levels than both men and estrogen non-users and the men had higher E2 levels and a higher DHEAS/CRT ratio than the estrogen non-users. There were no group differences in CRT levels. Men and estrogen-users had higher total (p < .01) and forward (p < .001) digit span scores compared with non-users. Women estrogen-users also had higher backward digit span scores than non-users (p < .05), while both groups of women performed better than men on category retrieval (p < .01). The implications of these findings with respect to hormonal influences on memory in elderly men and women are discussed.     

Short- and long-term prognosis after coronary artery bypass grafting in relation to smoking habits

A study was conducted to determine the conditions needed to achieve the equilibrium concentration for the epimerization of d-lysergic acid diethylamide (LSD) to iso-LSD. The reaction was followed by integration of the C-9 resonance of LSD and iso-LSD by proton nuclear magnetic resonance (NMR). The C-9 resonance of LSD and iso-LSD appear as singlets at 6.35 and 6.27 ppm respectively. Starting with pure LSD, the conversion to iso-LSD is attained at temperatures above 37 degrees C and pH levels over 7.0. At a pH of 7.0 or higher, the LSD/iso-LSD ratio of 9:1 is achieved after one week at 45 degrees C or two weeks at 37 degrees C. Starting with iso-LSD, the conversion to LSD requires more vigorous conditions. The 9:1 LSD/iso-LSD ratio is attained only after 6 weeks at a temperature of 45 degrees C and a pH of 9.7. At lower pH levels, the reaction proceeds more slowly. The 9:1 LSD/iso-LSD ratio is achieved whether the starting material is LSD or iso-LSD and therefore represents an equilibrium concentration (K = 9). In addition, the more vigorous conditions needed to achieve equilibrium of iso-LSD to LSD demonstrate the difficulty in extraction of the epimerizable proton of iso-LSD. This study is the first to quantitate the epimerization of LSD by NMR techniques and establishes the conditions needed to induce epimerization in solution.