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SUMMARY: Aims/Objectives: The aim of this study was to evaluate the hemostatic consequences of whole blood leukoreduction (LR). Background: Whole blood is being used for trauma resuscitation in the military, and an increasing number of civilian trauma centres across the nation. The benefits of LR, such as decreased infectious and transfusion‐related complications, are well established, but the effects on hemostatic parameters remain a concern. Methods: Twenty‐four units of whole blood were assigned to one of the four groups: non‐leukoreduced (NLR), leukoreduced at 1 h and a height of 33 in. (LR‐1), leukoreduced at 4 h and a height of 33 in. (LR‐4(33)), or leukoreduced at 4 h and a height of 28 in. (LR‐4(28)). Viscoelastic parameters, platelet aggregation, cell counts, physiological parameters and thrombin potential were evaluated immediately before and after LR, and on days 1, 7, 14 and 21 following LR. Results: The viscoelastic parameters and thrombin generation potential were unchanged between the groups. Platelet aggregation was reduced in the LR‐1 group compared with NLR after 7 days. The LR‐4(28) group also showed a trend of reduced platelet aggregation compared with NLR. Aggregation in LR‐4(33) was similar to NLR throughout the storage time. Physiological and electrolyte changes over the whole blood storage period were not affected by LR. Conclusion: Our study shows that whole blood can be LR at 4 h after collection and a height of 33 in. while maintaining platelet count and without altering platelet function and hemostatic performance. [ABSTRACT FROM AUTHOR]

Cognitive impairment can be influenced by a number of factors. The potential effect of nutrition has become a topic of increasing scientific and public interest. In particular, there are arguments that nutrients (food and/or supplements) such as vitamins, trace minerals, lipids, can affect the risk of cognitive decline and dementia, especially in frail elderly people at risk of deficiencies. Our objective in this paper is to review data relating diet to risk of cognitive decline and dementia, especially Alzheimer's disease (AD). We chose to focus our statements on homocysteine-related vitamins (B-vitamins), antioxidant nutrients (vitamins E and C, carotenoids, flavonoids, enzymatic cofactors) and dietary lipids. Results of epidemiological studies may sometimes appeared conflicting; however, certain associations are frequently found. High intake of saturated and trans-unsaturated (hydrogenated) fats were positively associated with increased risk of AD, whereas intake of polyunsaturated and monounsaturated fats were protective against cognitive decline in the elderly in prospective studies. Fish consumption has been associated with lower risk of AD in longitudinal cohort studies. Moreover, epidemiologic data suggest a protective role of the B-vitamins, especially vitamins B9 and B12, on cognitive decline and dementia. Finally, the results on antioxidant nutrients may suggest the importance of having a balanced combination of several antioxidant nutrients to exert a significant effect on the prevention of cognitive decline and dementia, while taking into account the potential adverse effects of these nutrients. There is no lack of attractive hypotheses to support research on the relationships between nutrition and cognitive decline. It is important to stress the need to develop further prospective studies of sufficiently long duration, including subjects whose diet is monitored at a sufficiently early stage or at least before disease or cognitive decline exist. Meta-analyses should be developed, and on the basis of their results the most appropriate interventional studies can be planned. These studies must control for the greatest number of known confounding factors and take into account the impact of the standard social determinants of food habits, such as the regional cultures, social status, and educational level. [ABSTRACT FROM AUTHOR]

Objective: To examine potential for bias in reported total energy intake on a Food Frequency Questionnaire (FFQ) among older adults. Design: Longitudinal cohort study. Subjects/setting: 2,706 Community-dwelling Black and White older adults, aged 70-79 years, enrolled in the Health, Aging, and Body Composition study. Multivariate logistic regression analyses were conducted with potential errors on reported total energy intake on the Food Frequency Questionnaire (FFQ) as the outcome variable and with cognitive ability, measured by the Modified Mini Mental State Exam (3MS) as the primary independent variable. The regression model controlled for site, race, gender, age, body size, and physical activity. Separate models were fit using 3MS as a continuous variable and for multiple 3MS cutpoints. All models revealed similar findings. Results: Cognitive ability was inversely associated with potential errors in reporting total energy intake, whereby a five-point increase in 3MS scores was associated with a 14% decreased likelihood of reporting errors (Odds Ratio=0.86, 95% Confidence Interval: 0.77, 0.95). Additionally, compared to White women, White men were 2 times more likely, and Black women and Black men were 3 times more likely, to have errors in reporting total energy intake. Conclusion: This study provides evidence that for older adults, lower cognition scores are associated with increased potential errors in reporting total energy intake. Applications: Dietary reporting from older adults may be inaccurate due to cognitive deficits. A brief assessment of cognitive function may assist clinicians in dietary evaluations and recommendation and may benefit studies using FFQ data where the measure of cognitive function could be utilized to stratify data analyses and conduct sensitivity analyses. [ABSTRACT FROM AUTHOR]

The clinical usefulness of the quantity height (cm)/plasma creatinine (Ht/Pcr) as a predictor of glomerular filtration rate (GFR) was investigated in 163 children with varying levels of renal function. Plasma creatinine levels (mumol/l) were measured by an automated reaction rate method. The results indicate that in rather more than half the children studied, an estimate of GFR adequate for ordinary clinical purposes will be obtained from Ht/Pcr, or from the derived formula GFR (ml/min per 1.73 m2) = 40 Ht/Pcr. The accuracy of the prediction is greatest in children with reduced function (GFR less than 80 ml/min per 1.73 m2) and in this group of patients a change of GFR of 19 ml/min per 1.73 m2 or more is reliably detected by this method. We conclude that Ht/Pcr is a clinically useful aid to the estimation of renal function, reducing the need for formal GFR measurements by at least half. [ABSTRACT FROM AUTHOR]

We describe 3 infants with nephrocalcinosis and terminal renal failure. In all 3 there was widespread oxalate deposition: biochemical evidence of primary hyperoxaluria was sought but the presence of severe renal failure and the lack of established normal values for urinary and plasma oxalate and glycollate in infants made this diagnosis difficult to establish. [ABSTRACT FROM AUTHOR]

Thirty-six patients with the onset of symptoms of systemic lupus erythematosus before age 20 years (23 aged less than 15 years at onset) were studied during a 15-year period. All had clinical evidence of nephritis. They were followed for a mean of 5 years (range 6 months to 13 years) or until death. Survival was calculated to be 77% at 10 years for those aged less than 15, and 74% for those aged less than 20, from the onset of clinical nephritis. At referral, renal function was already impaired in two-thirds of patients. Renal biopsies showed mild focal or proliferative changes in 19% of patients, membranous lesions in 11%, and diffuse proliferative lesions in 70%. Three (8%) patients died during follow-up, all from sepsis, and 3 (8%) others required chronic haemodialysis for terminal renal failure. The prognosis even of severe lupus nephritis in childhood and adolescence has improved in recent years. Side effects of treatment remain an important cause of death and morbidity. [ABSTRACT FROM AUTHOR]

. The responses of gravid female Lucilia cuprina to odours from sheep urine, faeces and gut mucus, and to odours from liver/sodium sulphide mixtures was tested using a bioassay which measured the movement and probing response of walking flies. The same bioassay was used to test the response to odours from cultures of bacteria isolated from liver/sodium sulphide and liver/water mixtures. A significant movement towards odours from faeces, gut mucus and urine was observed. Odours from cultures of the bacteria Proteus mirabilis, Dermatophilus congolensis and Serratia marcescens also elicited significant movement. A probing response was elicited by odours from gut mucus, fresh urine, liver/sodium sulphide mixtures and cultures of P.mirabilis, D.congolensis and gram-positive species. Odours from cultures of Pseudomonas aeruginosa, Entero-bacter aerogenes and Citrobacterfreundii did not elicit significant movement or probing. The movement and probing responses are discussed with reference to the possible uses of the substances tested as a bait for attracting L.cuprina. [ABSTRACT FROM AUTHOR]

Cerebral vasculitis following acute post-streptococcal glomerulonephritis (APSGN) is a rare neurological complication. An 11-year-old girl with biopsy proven APSGN developed an acute seizure disorder. Clinical and computed tomography findings were consistent with vasculitis. [ABSTRACT FROM AUTHOR]

BACKGROUND Findings from observational studies suggest that dietary patterns may offer protective benefits against cognitive decline, but data from clinical trials are limited. The Mediterranean--DASH Intervention for Neurodegenerative Delay, known as the MIND diet, is a hybrid of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet, with modifications to include foods that have been putatively associated with a decreased risk of dementia. METHODS We performed a two-site, randomized, controlled trial involving older adults without cognitive impairment but with a family history of dementia, a body-mass index (the weight in kilograms divided by the square of the height in meters) greater than 25, and a suboptimal diet, as determined by means of a 14-item questionnaire, to test the cognitive effects of the MIND diet with mild caloric restriction as compared with a control diet with mild caloric restriction. We assigned the participants in a 1:1 ratio to follow the intervention or the control diet for 3 years. All the participants received counseling regarding adherence to their assigned diet plus support to promote weight loss. The primary end point was the change from baseline in a global cognition score and four cognitive domain scores, all of which were derived from a 12-test battery. The raw scores from each test were converted to z scores, which were averaged across all tests to create the global cognition score and across component tests to create the four domain scores; higher scores indicate better cognitive performance. The secondary outcome was the change from baseline in magnetic resonance imaging (MRI)--derived measures of brain characteristics in a nonrandom sample of participants. RESULTS A total of 1929 persons underwent screening, and 604 were enrolled; 301 were assigned to the MIND-diet group and 303 to the control-diet group. The trial was completed by 93.4% of the participants. From baseline to year 3, improvements in global cognition scores were observed in both groups, with increases of 0.205 standardized units in the MIND-diet group and 0.170 standardized units in the control-diet group (mean difference, 0.035 standardized units; 95% confidence interval, -0.022 to 0.092; P=0.23). Changes in white-matter hyperintensities, hippocampal volumes, and total gray- and white-matter volumes on MRI were similar in the two groups. CONCLUSIONS Among cognitively unimpaired participants with a family history of dementia, changes in cognition and brain MRI outcomes from baseline to year 3 did not differ significantly between those who followed the MIND diet and those who followed the control diet with mild caloric restriction. (Funded by the National Institute on Aging; ClinicalTrials.gov number, NCT02817074.) [ABSTRACT FROM AUTHOR]

Background: Information regarding the prevalence of dizziness and its association with functional disability among African American and white residents from defined community populations is limited.Methods: A total of 6,158 persons 65 years and older (78.8% of age-eligible persons) completed in-home interviews that included three common measures of self-reported disability: the Katz Activities of Daily Living (ADL) Scale, the Rosow-Breslau Functional Health Scale, and the Nagi Physical Disability Scale. A stratified random sample of 729 persons underwent a detailed evaluation that included questions on the frequency and severity of dizziness, which was defined as having an episode of dizziness or lightheadedness at least once a month.Results: The overall prevalence of dizziness in this population was 9.6% (95% confidence interval [CI] 7.2-12.0). It increased with age, from 6.6% in those 65-74 years old, to 11.6% in those 75-84 years old, and to 18.4% in those persons > or =85 years old. It was more common in women (odds ratio [OR] 2.03, 95% CI 0.99-4.19) but was not associated with race. After adjusting for age, sex, and race, dizziness was associated with greater disability on the Rosow-Breslau (OR 2.29, 95% CI 1.18-4.46) and Nagi (OR 2.54, 95% CI 1.48-4.36) measures but not on the Katz ADL Scale (OR 1.18, 95% CI 0.64-2.20).Conclusions: Dizziness is common among older persons and is associated with functional disability. [ABSTRACT FROM AUTHOR]

Background: The relation of blood pressure to Alzheimer's disease (AD) is complex because both an association of high blood pressure with increased risk of the disease and lower blood pressure as a consequence of the disease are possible.Methods: We examined the cross-sectional association of blood pressure and AD in the Chicago Health and Aging Project (CHAP), a study of a geographically defined, biracial community. After in-home interviews with 6.162 residents > or =65 years, a stratified random sample of 729 participants was clinically evaluated; 709 had blood pressures measured, and 243 were diagnosed with AD.Results: In logistic regression models adjusted for age, sex, education, and race there was no association between blood pressure measured as a continuous variable and Alzheimer's disease. In categorical analyses, however, prevalence of Alzheimer's disease was significantly higher among persons with low systolic pressure (<130 mmHg) compared with the referent group of 130-139 mmHg (odds ratio [OR] = 2.2, 95% confidence interval [CI]: 1.2,4.1), and with low diastolic pressure (<70 mmHg) compared to the referent of 70-79 mmHg (OR = 1.8, 95% CI: I. 1,3.1). High systolic and diastolic categories were not statistically different from the referent group, although there was some evidence that the associations differed by race. The odds ratios changed little with further adjustment for apolipoprotein E genotype, antihypertensive medications, body mass, stroke, diabetes, and heart disease.Conclusion: These findings are consistent with previous studies showing associations between low blood pressure and AD, but longitudinal studies are needed to characterize cause-and-effect associations. [ABSTRACT FROM AUTHOR]