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Stereopsis in end-stage renal disease (ESRD)

Jones DJW, Harris JP, Butler LT, Vaux EC

Physiol Behav, 2017 03 15;171:1-6.
PMID: 28025091 DOI: 10.1016/j.physbeh.2016.12.029

We investigated an effect of end-stage renal disease (ESRD) on the visual system by measuring the ability of 21 patients to perceive depth in the random dot stereograms and circles of the Randot Test. To control for other factors which might influence performance on the tests of stereopsis, patients were compared with healthy controls matched for age, years of education, IQ, and general cognitive ability. Vernier acuity (thought to reflect mainly central processing) and Landolt acuity (more sensitive to retinal and optical abnormalities) were also measured, but the study did not include a formal ophthalmological examination. All controls could perceive depth in random dot stereograms, whereas 9/21 patients could not. Patients who could perceive depth had worse stereoacuity than did their matched controls. The patient group as a whole had worse Vernier and Landolt acuities than the controls. The stereoblind patient subgroup had similar Vernier acuity to the stereoscopic subgroup, but worse Landolt acuity, and was more likely to have peripheral vascular disease. We conclude that ESRD had affected structures both within the eye, and within the visual brain. However, the similarity of Vernier acuity and difference of Landolt acuity in the stereoblind and stereoscopic patient subgroups suggest that the differences in stereoscopic ability arise from abnormalities in the eyes rather than in the brain.

Matched MeSH terms: Activities of Daily Living
Fulltext Acquired Hemophilia of Unknown Etiology in an Elderly Man: Case Report

Stephen SE, Loong JLX, Hoong CK, Lim SM, Botross NP

Am J Case Rep, 2018 Jul 23;19:858-863.
PMID: 30033442 DOI: 10.12659/AJCR.909228

BACKGROUND Acquired hemophilia is a rare but potentially dangerous bleeding disorder caused by autoantibodies against coagulation factors. It affects 1 to 1.5 per 1 million people each year. While 50% of cases could be idiopathic, other causes include malignancies, diabetes, pregnancy, infection, and autoimmune disorders. CASE REPORT We report a case of a 90-year-old male who developed a spontaneous hematoma on the dorsum of his right hand, with no prior history of trauma or any other mucosal bleeding. His activated partial thromboplastin time (aPTT) was found to be prolonged (>180 seconds) with a very low level of factor VIII (0.1%). CONCLUSIONS As workups did not identify the source, including malignancy and autoimmune diseases, of his acquired hemophilia, it is believed to be idiopathic. He was started on intravenous recombinant factor VIIa (NovoSeven) to control the bleeding in combination with an immunosuppressive therapy of cyclophosphamide and prednisolone. In approximately 10% of patients with acquired hemophilia, underlying malignancy, such as squamous cell cancer, chronic lymphocytic leukemia, non-Hodgkin lymphoma, and multiple myeloma can present and commonly develop in elderly patients. Therefore, patients diagnosed with idiopathic acquired hemophilia should be given long-term follow up.

Matched MeSH terms: Activities of Daily Living
An action research on promotion of healthy ageing and risk reduction of chronic disease: a need assessment study among rural elderly Malays, care givers and health professionals

Nur Asyura Adznam S, Shahar S, Rahman SA, Yusof NA, Arshad F, Yassin Z, et al.

J Nutr Health Aging, 2009 Dec;13(10):925-30.
PMID: 19924355

OBJECTIVE: Prior to the development of a healthy ageing and risk reduction of chronic diseases intervention package for older people in Malaysia, a need assessment study was conducted to identify nutritional knowledge status and information needs, as part of an action research process.
DESIGN: A cross sectional study was conducted among 267 elderly people, 54 care givers and 66 health professionals in two rural areas of Peninsular of Malaysia (i.e Sabak Bernam, Selangor and Kuala Pilah, Negeri Sembilan). Information on nutritional knowledge was obtained from an interview based questionnaire for older subjects and caregiver and through self administered questionnaire from the health professionals. Anthropometric and functional measurements were also conducted among elderly subjects.
RESULTS: It was found that the elderly subjects had poor nutritional knowledge with 43.8% of them classified as having unsatisfactory nutritional knowledge, followed by moderately satisfactory (33.7%), very unsatisfactory (15.7%) and good (6.7%). Talks, counselling sessions with health professionals and electronic media such as television and radio were the most preferred nutrition education sources among elderly subjects and their care givers. The majority of health professionals studied (98.5%) had good nutritional knowledge. Although most of them (93.6%) were involved in management of the elderly, only 45.5% incorporated nutritional information component in this activity. Most of the health professionals used the guidelines for management of elderly patients (63.6%). However, nutritional knowledge was very minimal in these guidelines. Multiple regression analysis indicated that 'level education', involvement in 'social activities', presence of 'hearing problems', the Instrumental Activities of Daily Living (IADL) score, having previous 'nutritional information' and 'participation in healthy eating programme' were the major predictors of nutritional knowledge score among elderly subjects.
CONCLUSION: Based on the above findings it is thus, imperative that an appropriate nutritional intervention package and programme be developed so as to help improve nutritional knowledge and subsequently the nutritional status of the rural elderly Malays.

Matched MeSH terms: Activities of Daily Living
Factors associated with cognitive impairment in patients with Parkinson disease: an urban study

Rosdinom R, Fazli A, Ruzyanei NJ, Azlin B, Srijit D

Clin Ter, 2011;162(1):23-9.
PMID: 21448542

BACKGROUND AND AIMS: Parkinson disease (PD) is the second most prevalent neurodegenerative disorder after Alzheimer disease. Besides motor presentations, cognitive impairment is among the other likely complications as the illness progresses. This study aimed to determine the prevalence of cognitive impairment in PD and the factors associated with the cognitive impairment.
MATERIALS AND METHODS: A cross-sectional, descriptive study was conducted on all PD patients at different stages of their illness, in two major tertiary hospitals in Malaysia with their caregivers, over a three month period in 2002. Patients' cognitive functions were tested using the Mini Mental State Examination (MMSE). Important sociodemographic data and relevant clinical information of the patients as well as caregivers' information on income, duration of care-giving, relationship with the patient, and other relevant variables were gathered. Patients' level of functioning was assessed using the Activities of Daily Living (ADL) index. Staging of illness was done based on the Hoehn and Yahr Scale.
RESULTS: Out of 115 eligible patients, 35% were in the 60-69 age group with 57% in stage 2 of illness, A total of 29% of patients experienced various degrees of cognitive impairment , with almost half (47%) in the stage 3 and 4 exhibiting MMSE scores <24. Factors which were significantly associated with impaired cognitions were race, educational level and stage of illness.
CONCLUSION: Cognitive impairment was fairly common in PD and the severity of impairment in cognition and physical functioning increased with the advancement of the illness.

Matched MeSH terms: Activities of Daily Living