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The aims of the present study were to determine whether high-density lipoprotein (HDL) functionality-mediated cholesterol efflux is altered in Alzheimer's disease and to investigate the role and effect of amyloid-beta (Ap) in the regulation of the anti-atherogenic activity of HDL. Eighty-seven elderly subjects were recruited, of whom 27 were healthy, 27 had mild cognitive impairment (MCI), and 33 had mild Alzheimer's disease (mAD). Our results showed that total cholesterol levels are negatively correlated with the Mini-Mental State Examination (MMSE) score (r = -0.2602, p = 0.0182). HDL from the mAD patients was less efficient at mediating cholesterol efflux from J774 macrophages (p < 0.05) than HDL from the healthy subjects and MCI patients. While HDL from the MCI patients was also less efficient at mediating cholesterol efflux than HDL from the healthy subjects, the difference was not significant. Interestingly, the difference between the healthy subjects and the MCI and mAD patients with respect to the capacity of HDL to mediate cholesterol efflux disappeared when ATP-binding cassette transporter A1 (ABCAl)-enriched J774 macrophages were used. HDL fluidity was significantly inversely correlated with the MMSE scores (r = -0.4137, p < 0.009). In vitro measurements of cholesterol efflux using J774 macrophages showed that neither [beta][A.sub.1-40] nor [beta][A.sub.1-42] stimulate cholesterol efflux from unenriched J774 macrophages in basal or ABCA1-enriched J774 macrophages. Key words: HDL, cholesterol efflux, amyloid beta, Alzheimer's disease. Les presents travaux avaient pour but de determiner si l'efflux de cholesterol medie par les fonctionnalites des lipoproteines de haute densite (HDL) est modifie dans la maladie d'Alzheimer et d'etudier le role et l'effet de la substance beta-amyloide (pA) dans la regulation de l'activite antiatherogene des HDL. Nous avons inscrit a l'etude 87 sujets, dont 27 etaient en bonne sante, 27 presentaient des troubles cognitifs legers (TCL) et 33 etaient atteints d'une forme legere de la maladie d'Alzheimer (MAl). Nos resultats ont montre que les taux de cholesterol total etaient inversement proportionnels au score a l'examen mini mental (ou MMSE pour <>; r = -0,2602, p = 0,0182). Dans le groupe MAl, les HDL permettaient moins bien de medier l'efflux de cholesterol de macrophages J774 (p < 0,05) que chez les sujets en bonne sante et dans le groupe TCL. Les HDL permettaient moins bien de medier l'efflux de cholesterol dans le groupe TCL que chez les sujets en bonne sante, mais cette difference n'etait pas significative. Il est interessant de noter que la difference entre les sujets en bonne sante et les patients des groupes TCL et MAl quant a la capacite des HDL a medier l'efflux de cholesterol disparaissait quand on utilisait des macrophages J774 enrichis en ABCA1 (pour<>). L'effet des HDL sur le flux etait inversement proportionnel aux scores au MMSE (r = -0,4137, p < 0,009). Les mesures in vitro de l'eflux de cholesterol avec les macrophages J774 ont montre que la substance [[beta]A.sub.1-40] et la substance [[beta]A.sub.1-42] ne stimulent ni l'une ni l'autre l'efflux de cholesterol avec les macrophages J774 qui ne sont pas enrichis au debut de l'etude ni avec les macrophages J774 enrichis en ABCA1. [Traduit par la Redaction] Mots-cles: HDL, efflux de cholesterol, beta-amyloide, maladie d'Alzheimer., Introduction Alzheimer's disease (AD) is the principal cause of dementia worldwide, affecting approximately 35 million people. Because the major risk factor for AD is age, the aging of the population [...]

Purpose: Tooth selection is considered an important factor in the construction of complete dentures that function harmoniously and comfortably and preserve the denture-supporting tissues. To bring a scientific background to clinical impressions, the hypothesis that different cusp angles bring different levels of patient satisfaction was tested. Materials and Methods: Four different occlusar schemes were compared. The dependent variables (3 groups of visual analogue scores of patient satisfaction) were analyzed by means of multivariate analysis of variance (MANOVA) for repeated measures. Results: All MANOVAs showed nonsignificant results for the effect of tooth type on the 3 groups of variables (P values between 0.1 and 0.8). Conclusion: The results did not show statistically significant differences in patient satisfaction among the different occlusal schemes. It is recommended that future research use more sensitive instruments to evaluate this specific aspect of treatment success. [ABSTRACT FROM AUTHOR]

The Frontal Assessment Battery (FAB) has been shown to be useful in several clinical settings. The aim of the present study was to examine the performance of patients with traumatic brain injury (TBI) on the FAB and to predict their acute outcome. The FAB was administered to 89 patients with mild (27 = uncomplicated and 39 = complicated) and moderate (n = 23) TBI during hospitalization in an acute care setting. The length of stay in days (LOS), Glasgow Outcome Scale-Revised score (GOSE) and Disability Rating Scale (DRS) score were collected. Results showed no significant differences between the three groups on the FAB score, but age and education were significantly associated with the FAB score. Parietal lesions were associated with lower total FAB score, and with the Similarities, Motor series and Conflicting instructions subscales, while frontal lesions were associated with lower performance on the Motor series and Conflicting instructions subscales. Total FAB score was significantly correlated with all outcome measures, and together the FAB total score and the Glasgow Coma Scale (GCS) score explained 30.8% of the variance in the DRS score. The FAB may be useful clinically to acutely assess frontal and parietal lobe functions at bedside in patients with TBI and, in combination with the GCS score to measure TBI severity, can enable clinicians to predict early outcome. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to explore the effects of a multidisciplinary acquired brain injury rehabilitation out-patient program (5 d/week for 7 weeks) on improvements to participants’ activity and participation outcomes related to meal preparation and to determine whether gains are maintained at 3 and 6 months post program. Methods: A single case experimental design with repeated measures pre- and post-intervention with 7 adult participants with ABI and executive dysfunction (4 females, mean age 38 ± 10.1 years) was used. Results: A strong improvement effect between pre and post phases was found for number of errors on the Cooking Task for 6/7 participants; four participants showed significant improvement immediately after the program and at 3 and 6 months post. Six out of seven participants improved significantly on the Instrumental Activities of Daily Living Profile and four participants improved between the post and 6 month follow-up. Four out of seven participants showed significantly improved Life Habits scores pre- versus post-program. Conclusions: Significant improvements were observed in activity and participation outcomes related to preparing a meal in adults with ABI and executive dysfunction who participated in a 7-week multidisciplinary rehabilitation out-patient program. Treatment gains were maintained for the majority of participants at 3 and 6 months following the program. Implication of Rehabilitation: A 7-week multidisciplinary rehabilitation out-patient program appears to improve activities and participation; the effects are sustainable after 6 months. A detailed description of the therapeutic interventions provided during the cooking activity should help clinicians better understand what specific functions are solicited or required during a particular activity. Knowledge from this study may help guide clinicians in their work within this complex area of rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose:Investigate health care providers’ perceptions of referral and admission criteria to brain injury inpatient rehabilitation in two Canadian provinces. Methods:Health care providers (n = 345) from brain injury programs (13 acute care and 16 rehabilitation facilities) participated in a cross-sectional web-based survey. The participants rated the likelihood of patients (traumatic brain injury and cerebral hypoxia) to be referred/admitted to rehabilitation and the influence of 19 additional factors (e.g., tracheostomy). The participants reported the perceived usefulness of referral/admission policies and assessment tools used. Results:Ninety-one percent acute care and 98% rehabilitation participants reported the person with traumatic brain injury would likely or very likely be referred/admitted to rehabilitation compared to respectively 43% and 53% for the patient with hypoxia. Two additional factors significantly decreased the likelihood of referral/admission: older age and the combined presence of minimal learning ability, memory impairment and physical aggression. Some significant inter-provincial variations in the perceived referral/admission procedure were observed. Most participants reported policies were helpful. Similar assessment tools were used in acute care and rehabilitation. Conclusions:Health care providers appear to consider various factors when making decisions regarding referral and admission to rehabilitation. Variations in the perceived likelihood of referral/admission suggest a need for standardized referral/admission practices.Implications for RehabilitationVarious patient characteristics influence clinicians’ decisions when selecting appropriate candidates for inpatient rehabilitation.In this study, acute care clinicians were less likely to refer patients that their rehabilitation counter parts would likely have admitted and a patient with hypoxic brain injury was less likely to be referred or admitted in rehabilitation than a patient with a traumatic brain injury.Such discrepancies suggest that policy-makers, managers and clinicians should work together to develop and implement more standardized referral practices and more specific admission criteria in order to ensure equitable access to brain injury rehabilitation services. [ABSTRACT FROM PUBLISHER]