Specificity in the correlation of verbal memory and hippocampal neuron loss: dissociation of memory, language, and verbal intellectual ability

Fifty-nine patients with temporal-lobe epilepsy (28 left, 31 right) completed the Boston Naming Test (BNT), verbal subtests of the Wechsler Adult Intelligence Scale-Revised, and the Logical Memory Subtest of the Wechsler Memory Scale (WMS) before surgery. Performances by patients with left temporal seizure foci were significantly more impaired than those of patients with right seizure foci on the WMS Logical Memory subtest and the BNT. After surgical removal of the mesial temporal lobe structures, two blinded observers established volumetric cell densities for hippocampal subfields CA1, CA2, CA3, the hilar area, and the granule cell layer of area dentata. Statistically significant correlations existed only between percent retention scores and hippocampal neuron loss in CA3 and the hilar area for patients with left temporal seizure foci. None of the other dependent measures was significantly correlated with hippocampal neuron density in any subfield. These results support the hypothesis that certain verbal memory impairments are attributable to hippocampal damage specifically, and not to temporal lobe damage in general.

Impact of Marijuana Legalization in Colorado on Adolescent Emergency and Urgent Care Visits

PURPOSE

Approximately 6%-8% of U.S. adolescents are daily/past-month users of marijuana. However, survey data may not reliably reflect the impact of legalization on adolescents. The objective was to evaluate the impact of marijuana legalization on adolescent emergency department and urgent cares visits to a children's hospital in Colorado, a state that has allowed both medical and recreational marijuana.

METHODS

Retrospective review of marijuana-related visits by International Classification of Diseases codes and urine drug screens, from 2005 through 2015, for patients ≥ 13 and < 21 years old.

RESULTS

From 2005 to 2015, 4,202 marijuana-related visits were identified. Behavioral health evaluation was obtained for 2,813 (67%); a psychiatric diagnosis was made for the majority (71%) of these visits. Coingestants were common; the most common was ethanol (12%). Marijuana-related visits increased from 1.8 per 1,000 visits in 2009 to 4.9 in 2015. (p = < .0001) CONCLUSIONS: Despite national survey data suggesting no appreciable difference in adolescent marijuana use, our data demonstrate a significant increase in adolescent marijuana-associated emergency department and urgent cares visits in Colorado.

Volume changes in polycystic kidneys during chronic dialysis and after renal transplantation

Renal volume was determined by repeated CT scanning in 26 patients with adult polycystic kidney disease after institution of replacement therapy for terminal renal failure. Thirteen patients, treated for an average period of 6.7 years (SD 3.4, range 1.1-13.7), had a functioning necrokidney graft at the close of the study and had been grafted for 80.8% (SD 18) of the total treatment time. They showed a reduction of renal volume averaging 1.07% (SD 0.89) per month. Thirteen patients, treated for an average period of 5.7 years (SD 3.3, range 1.2-12.2), were on dialysis at the close of the study. Four had been on dialysis only, 9 had carried one or more (rejected) necrokidney grafts for 22.8% (SD 25) of the total treatment time. Three of them showed a significant increase in renal volume, whereas ten showed a decrease. The average change of renal volume in the entire group was -0.28% (SD 1.36) per month, significantly smaller than in the transplanted patients (p less than 0.01). It is concluded that polycystic kidneys shrink after successful grafting, whereas volume changes vary on dialysis treatment.

Dry Rehydratable Film Method for Enumerating Confirmed Escherichia coli in Poultry, Meats, and Seafood: Collaborative Study

A rehydratable dry-film plating method for Escherichia coli, the Petrifilm E. coli/Coliform (EC) Count Plate in foods, has been compared with the AOAC INTERNATIONAL most probable number (MPN) method. Eleven laboratories participated in the collaborative study. Three E. coli levels in 8 samples each of frozen raw ground turkey, frozen raw ground beef, and frozen cooked fish were tested in duplicate. Mean log counts for the Petri film plate procedure were not significantly different from those for the MPN procedure for cooked fish samples inoculated with low or high inocula levels, for samples of raw turkey inoculated at medium level, and for beef inoculated at low, medium, and high levels. Repeatability and reproducibility vari ances of the Petrifilm EC Plate method recorded at 24 h were as good as or better than those of the MPN method. The dry rehydratable film method for enumerating confirmed E. coli in poultry, meats, and seafood has been adopted first action by AOAC INTERNATIONAL.

Dry Rehydratable Film Method for Rapid Enumeration of Coliforms in Foods (3M™ Petrifilm™ Rapid Coliform Count Plate): Collaborative Study

A rehydratable dry-film plating method for coliforms in foods, the 3M™ Petrifilm™ Rapid Coliform Count plate method, was compared with the U.S. Food and Drug Administration's Bacteriological Analytical Manual method for nondairy foods and the American Public Health Association's Standard Methods for the Examination of Dairy Products (SMEDP) method for dairy foods. Six food types, vanilla ice cream, cheddar cheese, fresh refrigerated uncooked pasta, wheat flour, prepared frozen macaroni and cheese, and frozen hash browns, were analyzed for coliforms by 11 collaborating laboratories. For each food product tested, the collaborators received 8 blind samples consisting of a control sample and 3 levels of inoculated sample, each in duplicate. The mean log counts for the methods were comparable. The repeatability and reproducibility variances of the Petrifilm Rapid Coliform Count method at 14 and 24 h were not significantly different from those of the standard methods.

Application of a Standard Cross-Specialty Workup for Diagnosis and Metabolic Screening of Obese Adolescents With Polycystic Ovary Syndrome

PURPOSE

Polycystic ovary syndrome (PCOS) is a common disorder. The used diagnostic criteria and screening for related metabolic disease in adolescent girls with PCOS vary with medical specialty, causing discrepancies in care. We sought to improve and standardize care to guidelines for adolescents with PCOS and obesity.

METHODS

This is a quality improvement project in a multispecialty, tertiary care children's hospital. Providers in Adolescent Medicine, Gynecology, Pediatric Endocrinology, and Endocrine-Metabolic clinics participated. Diagnostic testing and metabolic screening data were collected for new patient encounters with PCOS and obesity, with two improvement cycles from December 2012 to March 2017. Providers received education on diagnostics tests and metabolic screening recommendations, and electronic medical record tools were created. The number of diagnostic and metabolic screening tests ordered per cycle and per clinic were analyzed and compared with baseline.

RESULTS

The preintervention cycle included 74 encounters-44 in Cycle 1 and 58 in Cycle 2. Diagnostic test completeness improved by Cycle 2 (46%-68%) for all clinics. Screening for metabolic disease only improved in Gynecology (27%-71%). Adolescent Medicine, Endocrinology, and Endocrine-Metabolic used note templates, and Adolescent Medicine and Gynecology used order sets. Note templates were associated with more diagnostic tests ordered in Endocrinology (30%-88%; p = .002).

CONCLUSIONS

Implementation of quality improvement measures improved the number of diagnostic and metabolic screening tests performed in new patient encounters for PCOS, although the most effective strategy varied by clinic type and electronic medical record habits. Similar efforts should be implemented to standardize care at other institutions.

Follow-Up Mental Health Care in Youth and Young Adults With Type 1 Diabetes After Positive Depression Screen and/or Suicidal Ideation

Individuals with type 1 diabetes have higher rates of depression and suicidal ideation than the general population, and symptoms of depression are often associated with higher A1C levels and complications. This study evaluated mental health follow-up rates in youth and young adults with type 1 diabetes who screened positive for depressive symptoms or suicidal ideation and identified differences between those who obtained follow-up mental health care and those who did not. Specifically, males were less likely to obtain follow-up, and those who had mental health follow-up had decreasing A1C over the following year. These findings suggest increased assistance and monitoring are needed to ensure follow-up mental health care is obtained.

A new tool to monitor training and performance of sport horses using global positioning system (GPS) with integrated GSM capabilities

Global Positioning Systems (GPS) are considered suitable to monitor the position and velocity of horses during cross-country competition or in training. Furthermore, simultaneous recording of life data such as heart rate could be useful to assess the horse's condition during exercise. To test the suitability and reliability of a commercially available GPS system with integrated heart rate recording system and with built in GSM for data transmission, the Fidelak Equipilot Type EP-2003-15/G-2.11 (EP-15/G) was evaluated first for reliability of pulse recording from a pulse generator within the physiological range of horses; furthermore distance, velocity and heart rate recordings were carried out on a standard 1000 m field track with five repetitions. Agreement (% deviation from actually measured distance and from stopwatch-distance based velocity calculations) and variability (Coefficient of Variation for distance, velocity, heart rate) were calculated. From the results it was safe to assume that the heart rate sensor recorded horse heart rates at a high degree of accuracy. Overall distances and velocities are in high agreement with actually measured values. However, overall variability expressed in terms of relative variability (C.V.) is smaller for distance recording (C.V. 0.68%) when compared to velocity (C.V. 1.01%). The system tested is suitable and reliable for simultaneously recording of distance, velocity and heart rates for horses during cross country exercise. GPS-based monitoring of movement along with simultaneous recording of physiological data and the possibility to call upon data will not only be of benefit for training horses or for surveillance during competition, it may also be suitable for distant patient monitoring and in behavioural studies as well as in veterinary medicine in general.

Reproductive Health Management of Female Adolescent Athletes With Relative-Energy Deficiency in Sport

The objective of this document is to guide the screening, diagnosis, and management of Relative Energy Deficiency in Sport (RED-S) in Adolescent/Young Adult (AYA) athletes to treat symptoms and reduce long-term sequelae with a focus on gynecologic aspects of the disorder. RED-S is a more comprehensive term for the condition previously known as the Female Athlete Triad. An overview of the clinical presentation, evaluation, and management of the reproductive health aspects of RED-S for female athletes is provided. For the purposes of this document, "female" refers to those designated female at birth, and "athlete" is defined as an individual who participates in regular physical activity. This document is intended for use by healthcare providers who care for female AYA athletes with RED-S.