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Find video protocols related to scientific articles indexed in Pubmed.
Asymmetric dimethylarginine, race, and mortality in hemodialysis patients.
Clin J Am Soc Nephrol
PUBLISHED: 06-26-2014
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Levels of asymmetric dimethylarginine, an inhibitor of nitric oxide synthase, are elevated in kidney disease and associated with mortality in white European hemodialysis populations. Nitric oxide production and degradation are partially genetically determined and differ by racial background. No studies have measured asymmetric dimethylarginine in African Americans on dialysis and assessed whether differences exist in its association with mortality by race.
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Depression and all-cause mortality in hemodialysis patients.
Am. J. Nephrol.
PUBLISHED: 03-20-2014
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There are limited data regarding the relationship between depression and mortality in hemodialysis (HD) patients.
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Cognitive Function and All-Cause Mortality in Maintenance Hemodialysis Patients.
Am. J. Kidney Dis.
PUBLISHED: 03-07-2014
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Cognitive impairment is common in hemodialysis patients and is associated with significant morbidity. Limited information exists about whether cognitive impairment is associated with survival and whether the type of cognitive impairment is important.
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Dietary modulators of statin efficacy in cardiovascular disease and cognition.
Mol. Aspects Med.
PUBLISHED: 02-17-2014
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Cardiovascular disease remains the leading cause of morbidity and mortality in the United States and other developed countries, and is fast growing in developing countries, particularly as life expectancy in all parts of the world increases. Current recommendations for the prevention of cardiovascular disease issued jointly from the American Academy of Cardiology and American Heart Association emphasize that lifestyle modification should be incorporated into any treatment plan, including those on statin drugs. However, there is a dearth of data on the interaction between diet and statins with respect to additive, complementary or antagonistic effects. This review collates the available data on the interaction of statins and dietary patterns, cognition, genetics and individual nutrients, including vitamin D, niacin, omega-3 fatty acids, fiber, phytochemicals (polyphenols and stanols) and alcohol. Of note, although the available data is summarized, the scope is limited, conflicting and disparate. In some cases it is likely there is unrecognized synergism. Virtually no data are available describing the interactions of statins with dietary components or dietary pattern in subgroups of the population, particularly those who may benefit most were positive effects identified. Hence, it is virtually impossible to draw any firm conclusions at this time. Nevertheless, this area is important because were the effects of statins and diet additive or synergistic harnessing the effect could potentially lead to the use of a lower intensity statin or dose.
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Macular pigment optical density is related to cognitive function in older people.
Age Ageing
PUBLISHED: 01-15-2014
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the xanthophylls lutein (L) and zeaxanthin (Z) exist in relatively high concentration in multiple central nervous tissues (e.g. cortex and neural retina). L + Z in macula (i.e. macular pigment, MP) are thought to serve multiple functions, including protection and improvement of visual performance. Also, L + Z in the macula are related to L + Z in the cortex.
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FGF-23 and cognitive performance in hemodialysis patients.
Hemodial Int
PUBLISHED: 10-24-2013
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Although cognitive impairment is common in hemodialysis patients, the etiology of and risk factors for its development remain unclear. Fibroblast growth factor 23 (FGF-23) levels are elevated in hemodialysis patients and are associated with increased mortality and left ventricular hypertrophy. Despite FGF-23 being found within the brain, there are no prior studies assessing whether FGF-23 levels are associated with cognitive performance. We measured FGF-23 in 263 prevalent hemodialysis patients in whom comprehensive neurocognitive testing was also performed. The cross-sectional association between patient characteristics and FGF-23 levels was assessed. Principal factor analysis was used to derive two factors from cognitive test scores, representing memory and executive function, which carried a mean of 0 and a standard deviation of 1. Multivariable linear regression adjusting for age, sex, education status, and other relevant covariates was used to explore the relationship between FGF-23 and each factor. Mean age was 63 years, 46% were women and 22% were African American. The median FGF-23 level was 3098 RU/mL. Younger age, lower prevalence of diabetes, longer dialysis vintage, and higher calcium and phosphorus were independently associated with higher FGF-23 levels. Higher FGF-23 was independently associated with a lower memory score (per doubling of FGF-23, ??=?-0.08 SD [95% confidence interval, CI: -0.16, -0.01]) and highest quartile vs. lowest quartile (??=?-0.42 SD [-0.82, -0.02]). There was no definite association of FGF 23 with executive function when examined as a continuous variable (??=?-0.03 SD [-0.10, 0.04]); however, there was a trend in the quartile analysis (??=?-0.28 SD [-0.63, 0.07], P?=?0.13, for 4th quartile vs. 1st quartile). FGF-23 was associated with worse performance on a composite memory score, including after adjustment for measures of mineral metabolism. High FGF-23 levels in hemodialysis patients may contribute to cognitive impairment.
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Association of sleep disturbances with cognitive impairment and depression in maintenance hemodialysis patients.
J. Nephrol.
PUBLISHED: 08-24-2013
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There are few data on the relationship of sleep with measures of cognitive function and symptoms of depression in dialysis patients.
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Characterization of cognitive dysfunction in Sjögrens syndrome patients.
Clin. Rheumatol.
PUBLISHED: 06-18-2013
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Sjögrens syndrome is an autoimmune disorder primarily affecting women, with decreased saliva and tear production as the principal characteristic. Cognitive, neurological, and psychiatric disorders also are associated with Sjögrens. The present study addressed the hypothesis that patients with Sjögrens syndrome differ significantly from matched controls in the prevalence and impact of a number of neuropsychiatric abnormalities. Sjögrens patients and controls (n?=?37 per group) underwent medical and psychiatric evaluation, demographic assessments, quality of life and symptom evaluation, and extensive testing of cognitive function and memory. Patients and controls were closely matched for age, gender distribution, verbal IQ, marital status, educational level, employment status, and current/past medical or psychiatric history. On most subjective self-ratings, Sjögrens patients reported greater fatigue, impaired physical functioning, feeling depressed, and autonomic symptomatology compared to controls. Impaired memory was described mainly as loss of thought continuity in the midst of a task or activity. However, the majority of objective measures of cognition, psychomotor function, and memory showed minimal differences between groups. Sjögrens patients rate themselves as impaired on multiple ratings of emotional, cognitive, and physical function, but objective measures of cognition reveal fewer substantive differences between patients and matched controls. Sjögrens patients perceive deteriorated physical function over time, but they achieve a level of functioning comparable to controls despite the burden of their illness.
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Cognitive Performance before and during Hemodialysis: A Randomized Cross-Over Trial.
Nephron Clin Pract
PUBLISHED: 05-17-2013
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Background and Aims: Hemodialysis (HD) patients are educated and counseled during the HD procedure. There are few studies assessing whether cognitive performance varies with dialysis. Methods: Using a randomized cross-over design, 40 patients were assigned to one of two sequences: testing 1 h before dialysis followed 1 month later by testing during the first hour of dialysis (n = 21) versus testing during the first hour of dialysis followed 1 month later by 1 h before dialysis (n = 19). Cognitive tests were administered at each testing period. Mixed regression models evaluated for a dialysis effect (difference between test performance before vs. during dialysis) while adjusting for potential learning (difference between first and second tests). Results: In models accounting for period of testing, there was no difference in test performance between 1 h before versus during the first hour of HD for all administered cognitive tests (p > 0.05). A learning effect was detected between first and second test administration in two tests, specifically, the Word List Learning and the Digit Symbol Substitution Test. Conclusions: We found no difference in cognitive performance depending on the time of testing, suggesting that cognitive tests performed during the first hour of dialysis are a valid assessment of cognitive performance. © 2013 S. Karger AG, Basel.
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Relationship of cravings with weight loss and hunger. Results from a 6 month worksite weight loss intervention.
Appetite
PUBLISHED: 04-07-2013
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We examined the association of food cravings with weight loss and eating behaviors in a lifestyle intervention for weight loss in worksites. This research was part of a randomized controlled trial of a 6-month weight loss intervention versus a wait-listed control in 4 Massachusetts worksites. The intervention emphasized reducing energy intake by adherence to portion-controlled menu suggestions, and assessments were obtained in 95 participants at baseline and 6 months including non-fasting body weight, food cravings (Craving Inventory and Food Craving Questionnaire for state and trait) and the eating behavior constructs restraint, disinhibition and hunger (Eating Inventory). There were statistically significant reductions in all craving variables in the intervention group compared to the controls. Within the intervention group, changes in craving-trait were significantly associated with weight loss after controlling for baseline weight, age, gender and worksite. However, in a multivariate model with craving-trait and eating behaviors (restraint, disinhibition and hunger), hunger was the only significant predictor of weight change. In contrast to some previous reports of increased food cravings with weight loss in lifestyle interventions, this study observed a broad reduction in cravings associated with weight loss. In addition, greater reductions in craving-trait were associated with greater weight change, but craving-trait was not a significant independent correlate of weight change when hunger was included in statistical models. Studies are needed to examine the effectiveness of hunger suppressing versus craving-suppressing strategies in lifestyle interventions for obesity.
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Low 25-hydroxyvitamin D levels and cognitive impairment in hemodialysis patients.
Clin J Am Soc Nephrol
PUBLISHED: 02-28-2013
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25-hydroxyvitamin D (25[OH]D) deficiency and cognitive impairment are both prevalent in hemodialysis patients in the United States. This study tested the hypothesis that 25(OH)D deficiency may be associated with cognitive impairment because of its vasculoprotective, neuroprotective, and immune-modulatory properties.
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Association between linear measurements of corpus callosum and gait in the elderly.
Eur Radiol
PUBLISHED: 02-07-2013
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Segmentation and diffusion-tensor-imaging of the corpus callosum (CC) have been linked to gait impairment. However, such measurements are impracticable in clinical routine. The purpose of this study was to evaluate the association between simple linear measurements of CC thickness with gait.
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Mediterranean diet, healthy eating index 2005, and cognitive function in middle-aged and older Puerto Rican adults.
J Acad Nutr Diet
PUBLISHED: 01-29-2013
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Adherence to a Mediterranean diet has recently been shown to protect against cognitive decline and dementia. It remains unclear, however, whether such protection extends to different ethnic groups and middle-aged individuals and how it might compare with adherence to the US Department of Agricultures 2005 Dietary Guidelines for Americans (measured with Healthy Eating Index 2005 [HEI 2005]). This study examined associations between diet quality, as assessed by the Mediterranean diet and HEI 2005, and cognitive performance in a sample of 1,269 Puerto Rican adults aged 45 to 75 years and living in the Greater Boston area of Massachusetts. Dietary intake was assessed with a food frequency questionnaire specifically designed for and validated with this population. Adherence to the Mediterranean diet was assessed with a 0- to 9-point scale, and the HEI 2005 score was calculated with a maximum score of 100. Cognitive performance was measured with a battery of seven tests and the Mini Mental State Examination was used for global cognitive function. Greater adherence to the Mediterranean diet was associated with higher Mini Mental State Examination score (P trend=0.012) and lower likelihood (odds ratio=0.87 for each additional point; 95% CI 0.80 to 0.94; P<0.001) of cognitive impairment, after adjustment for confounders. Similarly, individuals with higher HEI 2005 score had higher Mini Mental State Examination score (P trend=0.011) and lower odds of cognitive impairment (odds ratio=0.86 for each 10 points; 95% CI 0.74 to 0.99; P=0.033). In conclusion, high adherence to either the Mediterranean diet or the diet recommended by the US Department of Agriculture 2005 Dietary Guidelines for Americans can protect cognitive function in middle-aged and older adults.
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Eating behaviors as predictors of weight loss in a 6 month weight loss intervention.
Obesity (Silver Spring)
PUBLISHED: 01-20-2013
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To examine associations between eating behavior constructs and weight loss (WL) in a 6-month WL intervention in worksites.
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Frequency of and risk factors for poor cognitive performance in hemodialysis patients.
Neurology
PUBLISHED: 01-09-2013
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There are few detailed data on cognition in patients undergoing dialysis. We evaluated the frequency of and risk factors for poor cognitive performance using detailed neurocognitive testing.
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Relationship between Serum and Brain Carotenoids, ?-Tocopherol, and Retinol Concentrations and Cognitive Performance in the Oldest Old from the Georgia Centenarian Study.
J Aging Res
PUBLISHED: 01-04-2013
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Oxidative stress is involved in age-related cognitive decline. The dietary antioxidants, carotenoids, tocopherols, and vitamin A may play a role in the prevention or delay in cognitive decline. In this study, sera were obtained from 78 octogenarians and 220 centenarians from the Georgia Centenarian Study. Brain tissues were obtained from 47 centenarian decedents. Samples were analyzed for carotenoids, ?-tocopherol, and retinol using HPLC. Analyte concentrations were compared with cognitive tests designed to evaluate global cognition, dementia, depression and cognitive domains (memory, processing speed, attention, and executive functioning). Serum lutein, zeaxanthin, and ?-carotene concentrations were most consistently related to better cognition (P < 0.05) in the whole population and in the centenarians. Only serum lutein was significantly related to better cognition in the octogenarians. In brain, lutein and ?-carotene were related to cognition with lutein being consistently associated with a range of measures. There were fewer significant relationships for ?-tocopherol and a negative relationship between brain retinol concentrations and delayed recognition. These findings suggest that the status of certain carotenoids in the old may reflect their cognitive function. The protective effect may not be related to an antioxidant effect given that ?-tocopherol was less related to cognition than these carotenoids.
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Cognitive dysfunction and depression in adult kidney transplant recipients: baseline findings from the FAVORIT Ancillary Cognitive Trial (FACT).
J Ren Nutr
PUBLISHED: 06-07-2011
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Hyperhomocysteinemia and B-vitamin deficiency may be treatable risk factors for cognitive impairment and decline. Hyperhomocysteinemia, cognitive impairment, and depression are all common in individuals with kidney disease, including kidney transplant recipients. Accordingly, we assessed the prevalence of cognitive impairment and depressive symptoms in transplant recipients and their association with kidney function, plasma total homocysteine, and B-vitamin concentrations.
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Habitual sugar intake and cognitive function among middle-aged and older Puerto Ricans without diabetes.
Br. J. Nutr.
PUBLISHED: 06-01-2011
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Intake of added sugars, mainly fructose and sucrose, has been associated with risk factors for cognitive impairment, such as obesity, the metabolic syndrome and type 2 diabetes. The objective of this analysis was to examine whether habitual intakes of total sugars, added sugars, sugar-sweetened beverages or sweetened solid foods are associated with cognitive function. The present study included 737 participants without diabetes, aged 45-75 years, from the Boston Puerto Rican Health Study, 2004-9. Cognitive function was measured with a battery of seven tests: Mini-Mental State Examination (MMSE), word list learning, digit span, clock drawing, figure copying, and Stroop and verbal fluency tests. Usual dietary intake was assessed with a validated FFQ. Greater intakes of total sugars, added sugars and sugar-sweetened beverages, but not of sugar-sweetened solid foods, were significantly associated with lower MMSE score, after adjusting for covariates. Adjusted OR for cognitive impairment (MMSE score < 24) were 2.23 (95 % CI 1.24, 3.99) for total sugars and 2.28 (95 % CI 1.26, 4.14) for added sugars, comparing the highest with lowest intake quintiles. Greater intake of total sugars was also significantly associated with lower word list learning score. In conclusion, higher sugar intake appears to be associated with lower cognitive function, but longitudinal studies are needed to clarify the direction of causality.
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Cardiovascular disease and cognitive function in maintenance hemodialysis patients.
Am. J. Kidney Dis.
PUBLISHED: 03-31-2011
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Cardiovascular disease (CVD) and cognitive impairment are common in dialysis patients. Given the proposed role of microvascular disease on cognitive function, particularly cognitive domains that incorporate executive functions, we hypothesized that prevalent systemic CVD would be associated with worse cognitive performance in hemodialysis patients.
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Cognitive function and dialysis adequacy: no clear relationship.
Am. J. Nephrol.
PUBLISHED: 11-08-2010
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Cognitive impairment is common in hemodialysis patients and may be impacted by multiple patient and treatment characteristics. The impact of dialysis dose on cognitive function remains uncertain, particularly in the current era of increased dialysis dose and flux.
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Urinary 8-hydroxy-2-deoxyguanosine and cognitive function in Puerto Rican adults.
Am. J. Epidemiol.
PUBLISHED: 07-09-2010
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DNA oxidative stress has been suggested as an important pathogenic mechanism in cognitive impairment and dementia. With baseline data collected from 2004 to 2008, the authors examined whether urinary 8-hydroxy-2-deoxyguanosine (8-OHdG), a biomarker of global DNA oxidation, was associated with cognitive function in a sample of 1,003 Puerto Rican adults, aged 45-75 years, living in Boston, Massachusetts, and the surrounding area. Cognitive function was measured by using a battery of 7 tests: the Mini-Mental State Examination, word list learning, digit span, clock drawing and figure copying, Stroop, and verbal fluency tests. The primary outcome was a global cognitive score, averaging standardized scores across all cognitive tests. A higher 8-OHdG concentration was significantly associated with lower global cognitive scores, after adjustment for age, education, status of the gene for apolipoprotein E (APOE), and other covariates (P(trend) = 0.01). The difference in the global score, comparing participants in the 2 extreme 8-OHdG quartiles, was -0.11 (95% confidence interval: -0.20, -0.02), which was equivalent to accelerating cognitive aging by about 4 years, as observed in this population. Prospective studies are needed to elucidate whether elevated urinary 8-OHdG concentrations can predict the rate of cognitive decline and incident dementia.
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Tai Chi on psychological well-being: systematic review and meta-analysis.
BMC Complement Altern Med
PUBLISHED: 05-21-2010
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Physical activity and exercise appear to improve psychological health. However, the quantitative effects of Tai Chi on psychological well-being have rarely been examined. We systematically reviewed the effects of Tai Chi on stress, anxiety, depression and mood disturbance in eastern and western populations.
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Tandem dosing of samarium-153 ethylenediamine tetramethylene phosphoric acid with stem cell support for patients with high-risk osteosarcoma.
Cancer
PUBLISHED: 04-21-2010
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Samarium-153 ethylenediamine tetramethylene phosphoric acid (153Sm-EDTMP) is a radiopharmaceutical that has been used to treat osteosarcoma. The authors conducted a phase 2 study to test safety and response of high-risk osteosarcoma to tandem doses of 153Sm-EDTMP and to determine correlation between radiation delivered by low and high administered activities.
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Depression and cognitive function in maintenance hemodialysis patients.
Am. J. Kidney Dis.
PUBLISHED: 01-03-2010
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Both depression and cognitive impairment are common in hemodialysis patients, are associated with adverse clinical outcomes, and place an increased burden on health care resources.
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Diffusion tensor imaging, white matter lesions, the corpus callosum, and gait in the elderly.
Stroke
PUBLISHED: 10-01-2009
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Gait impairment is common in the elderly, especially those with stroke and white matter hyperintensities on conventional brain MRI. Diffusion tensor imaging (DTI) is more sensitive to white matter damage than conventional MRI. The relationship between DTI measures and gait has not been previously evaluated. Our purpose was to investigate the relationship between the integrity of white matter in the corpus callosum as determined by DTI and quantitative measures of gait in the elderly.
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Validity of estimated dietary eicosapentaenoic acid and docosahexaenoic acid intakes determined by interviewer-administered food frequency questionnaire among older adults with mild-to-moderate cognitive impairment or dementia.
Am. J. Epidemiol.
PUBLISHED: 05-11-2009
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Epidemiologic research is increasingly being focused on elderly persons, many of whom exhibit mild-to-moderate cognitive impairment. This presents a challenge for collection and interpretation of self-reported dietary data. There are few reports on the impact of cognitive function and dementia on the validity of self-reported dietary intakes. Using plasma phospholipid fatty acid profiles as a biomarker of intake, the authors assessed the validity of an interviewer-administered food frequency questionnaire (FFQ) to estimate intakes of 2 marine-based omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), among 273 community-dwelling adults aged > or =60 years participating in the Nutrition, Aging, and Memory in Elders Study (Boston, Massachusetts, 2002-2008). Age- and energy-adjusted Pearson correlation coefficients for correlations between dietary intakes and plasma phospholipids were consistent across categories of high and low cognitive function (r = 0.48), based on Mini-Mental State Examination score, and were similar across clinically diagnosed categories of normal functioning (r = 0.49), mild cognitive impairment (r = 0.45), and dementia (r = 0.52). The FFQ ranked 78% of subjects to within 1 quartile of their plasma phospholipid EPA + DHA quartile. This frequency was consistently high across all cognitive categories. With interviewer administration, this FFQ seems to be a valid method of assessing dietary EPA + DHA intake in older adults with mild-to-moderate cognitive impairment.
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Vitamin D is associated with cognitive function in elders receiving home health services.
J. Gerontol. A Biol. Sci. Med. Sci.
PUBLISHED: 04-17-2009
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The objective of this study was to examine the association between 25-hydroxyvitamin D, 25(OH)D, and cognitive function.
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Dose-finding study of 153Sm-EDTMP in patients with poor-prognosis osteosarcoma.
Cancer
PUBLISHED: 04-02-2009
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Samarium-153 ethylenediaminetetramethylene phosphonic acid ((153)Sm-EDTMP) has been used to treat patients with high-risk osteosarcoma. The purpose of the current study was to determine the maximally tolerated dose of (153)Sm-EDTMP that permits hematopoietic recovery within 6 weeks.
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Albuminuria, cognitive functioning, and white matter hyperintensities in homebound elders.
Am. J. Kidney Dis.
PUBLISHED: 03-21-2009
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Albuminuria, a kidney marker of microvascular disease, may herald microvascular disease elsewhere, including in the brain.
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Apolipoprotein C3 polymorphisms, cognitive function and diabetes in Caribbean origin Hispanics.
PLoS ONE
PUBLISHED: 03-02-2009
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Apolipoprotein C3 (APOC3) modulates triglyceride metabolism through inhibition of lipoprotein lipase, but is itself regulated by insulin, so that APOC3 represents a potential mechanism by which glucose metabolism may affect lipid metabolism. Unfavorable lipoprotein profiles and impaired glucose metabolism are linked to cognitive decline, and all three conditions may decrease lifespan. Associations between apolipoprotein C3 (APOC3) gene polymorphisms and impaired lipid and glucose metabolism are well-established, but potential connections between APOC3 polymorphisms, cognitive decline and diabetes deserve further attention.
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Food insecurity and cognitive function in Puerto Rican adults.
Am. J. Clin. Nutr.
PUBLISHED: 02-18-2009
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Food insecurity is associated with nutrient inadequacy and a variety of unfavorable health outcomes. However, little is known about whether food security is associated with lower cognitive function in the elderly.
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The association between small vessel infarcts and the activities of amyloid-? peptide degrading proteases in apolipoprotein E4 allele carriers.
Angiology
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Small vessel (SV) and large vessel (LV) brain infarcts are distinct pathologies. Using a homebound elderly sample, the numbers of either infarct subtypes were similar between those apolipoprotein E4 allele (ApoE4) carriers (n = 80) and noncarriers (n = 243). We found that the higher the number of SV infarcts, but not LV infarcts, a participant had, the higher the activity of substrate V degradation in serum especially among ApoE4 carriers (? = +0.154, SE = 0.031, P < .0001) after adjusting for the confounders. Since substrate V degradation could be mediated by insulin-degrading enzyme (IDE) or/and angiotensin-converting enzyme (ACE), but no relationship was found between SV infarcts and specific ACE activities, blood IDE may be a useful biomarker to distinguish the brain infarct subtypes. Insulin-degrading enzyme in blood may also imply an important biomarker and a pathological event in Alzheimer disease through SV infarcts in the presence of ApoE4.
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Anatomic brain disease in hemodialysis patients: a cross-sectional study.
Am. J. Kidney Dis.
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Although dialysis patients are at high risk of stroke and have a high burden of cognitive impairment, there are few reports of anatomic brain findings in the hemodialysis population. Using magnetic resonance imaging of the brain, we compared the prevalence of brain abnormalities in hemodialysis patients with that in a control population without known kidney disease.
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Phase I dose-escalation trial of clofarabine followed by escalating doses of fractionated cyclophosphamide in children with relapsed or refractory acute leukemias.
Pediatr Blood Cancer
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By inhibiting DNA repair, clofarabine (CLO) may augment cyclophosphamide (CY)-induced DNA damage and apoptosis. We performed a Phase I study for refractory and/or relapsed (R/R) leukemia in children to determine maximum-tolerated dose (MTD) of time-sequential CLO followed by CY.
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Status of vitamins B-12 and B-6 but not of folate, homocysteine, and the methylenetetrahydrofolate reductase C677T polymorphism are associated with impaired cognition and depression in adults.
J. Nutr.
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The C677T polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene differs in frequency in various ethnic groups that have differing prevalence of age-related cognitive impairments. We used a series of neuro-psychological tests to examine the association of the MTHFR C677T polymorphism with cognition and depression and also to assess whether genotype modifies the association of folate and homocysteine with these outcomes. This study analyzed pooled cross-sectional data from 2 ethnically diverse cohorts of community-living adults: the Boston Puerto Rican Health Study (n = 939) and the Nutrition, Aging, and Memory in Elders study (n = 1017). Individuals in both cohorts underwent anthropometric and laboratory measurements and dietary and health assessments using validated questionnaires between the years 2003 and 2007. Cognitive outcomes included measures of global cognition [Mini-Mental Status Exam (MMSE)], depression (Center for Epidemiological Studies Depression Scale), and 3 factor scores for the domains of attention, executive function, and memory that were derived from a detailed set of neuropsychological tests. Low plasma vitamin B-12 concentrations were associated with poorer MMSE scores and higher depression scores, and low vitamin B-6 concentrations were associated with lower MMSE and worse attention and executive function in the multivariate analysis. In contrast, MTHFR genotype, folate, and homocysteine were not associated with cognition or depression in either ethnicity-pooled or stratified analysis. The current study did not find evidence of an association between the MTHFR C677T TT genotype and impaired cognition or depression in a population with adequate folate status and a high prevalence of cognitive impairment and depression.
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Measures of blood pressure and cognition in dialysis patients.
Hemodial Int
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There are few reports on the relationship of blood pressure with cognitive function in maintenance dialysis patients. The Cognition and Dialysis Study is an ongoing investigation of cognitive function and its risk factors in six Boston area hemodialysis units. In this analysis, we evaluated the relationship between different domains of cognitive function with systolic and diastolic blood pressure, pulse pressure, and intradialytic changes in systolic blood pressure, using univariate and multivariable linear regression models adjusted for age, sex, race, education, and primary cause of end-stage renal disease. Among 314 participants, mean age was 63 years; 47% were female, 22% were African American, and 48% had diabetes. The mean (SD) of systolic blood pressure, diastolic blood pressure, pulse pressure, and intradialytic change in systolic blood pressure were 141 (21), 73 (12), 68 (15), and -10 (24) mmHg, respectively. In univariate analyses, the performance on cognitive tests primarily assessing executive function and processing speeds was worse among participants with lower diastolic blood pressure and higher pulse pressure. These relationships were not statistically significant, however, in multivariable analyses. There was no association between cognitive function and systolic blood pressure or intradialytic change in systolic blood pressure in either univariate or multivariable analyses. We found no association between different measures of blood pressure and cognitive function in cross-sectional analysis. Longitudinal studies are needed to confirm these results.
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The kidney disease quality of life cognitive function subscale and cognitive performance in maintenance hemodialysis patients.
Am. J. Kidney Dis.
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Cognitive impairment is common but often undiagnosed in patients with end-stage renal disease, in part reflecting limited validated and easily administered tools to assess cognitive function in dialysis patients. Accordingly, we assessed the utility of the Kidney Disease Quality of Life Cognitive Function (KDQOL-CF) scale in comparison to an extensive neuropsychological battery, building on a prior assessment of this potential cognitive screen.
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Clinical prediction of fall risk and white matter abnormalities: a diffusion tensor imaging study.
Arch. Neurol.
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The Tinetti scale is a simple clinical tool designed to predict risk of falling by focusing on gait and stance impairment in elderly persons. Gait impairment is also associated with white matter (WM) abnormalities.
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