Biomedical subjects

M Sliwinski

Publications and source records attributed to M Sliwinski.

At least 19 recordsLinked to original sources

PubMed2000

Cognitive performance in surgically menopausal women on estrogen.

Estrogen replacement therapy (ERT) may help maintain normal cognitive function. Nondemented surgically menopausal women on ERT (n = 10) enrolled in a longitudinal aging study performed better than age- and education-matched control subjects (n = 25) on selected tests of verbal memory and constructional ability. These results suggest that ERT initiated soon after surgical menopause can have long-term neuroprotective effects in cognitively intact women.

Aged↗

PubMed2000

Verbal pragmatics following unilateral stroke: emotional content and valence.

Verbal pragmatic aspects of discourse production were examined in 16 right brain-damaged (RBD), 16 left brain-damaged (LBD), and 16 normal control right-handed adults. The facilitation effect of emotional content, valence hypothesis, and relationship between pragmatics and emotion were evaluated. Participants produced monologues while recollecting emotional and nonemotional experiences. Transcribed monologues were rated for appropriateness on 6 pragmatic features: conciseness, lexical selection, quantity, relevancy, specificity, and topic maintenance. Overall, brain-damaged groups were rated as significantly less appropriate than normals. Consistent with the facilitation effect, emotional content enhanced pragmatic performance of LBD aphasic participants yet suppressed performance of RBD participants. Contrary to the valence hypothesis, RBD participants were more impaired for positive emotions and LBD participants for negative emotions. Pragmatic appropriateness was not strongly correlated with a measure of emotional intensity.

Adult↗

PubMed2000

The sensitivity and specificity of self-reported symptoms in individuals with traumatic brain injury.

In this study, self-reported symptoms (cognitive, physical, behavioural/affective) from the TIRR Symptom Checklist are compared across six panels: 135 individuals with mild TBI, 275 with moderate/severe TBI, 287 with no disability, 104 with spinal cord injury, 197 who are HIV positive and 107 who had undergone liver transplantation. Participants with TBI and SCI were at least 1 year post-injury. Individuals with TBI reported significantly more symptoms than other panels. Symptom reports in the TBI panels were independent of demographic variables (gender, education, income, ethnicity, age), as well as time since injury and depression. Five of the 67 symptoms were found to be sensitive/specific to TBI in general; 25 symptoms were sensitive/specific to mild TBI (23 were cognitive, one physical and one behavioural/affective). Implications of these results in terms of current debates about the 'reality' of symptom reports in individuals with mild TBI are discussed, as well as implications for using symptom checklists for TBI screening.

Activities of Daily Living↗

PubMed1999

Phylogenetic characterization of novel transport protein families revealed by genome analyses.

As a result of recent genome sequencing projects as well as detailed biochemical, molecular genetic and physiological experimentation on representative transport proteins, we have come to realize that all organisms possess an extensive but limited array of transport protein types that allow the uptake of nutrients and excretion of toxic substances. These proteins fall into phylogenetic families that presumably reflect their evolutionary histories. Some of these families are restricted to a single phylogenetic group of organisms and may have arisen recently in evolutionary time while others are found ubiquitously and may be ancient. In this study we conduct systematic phylogenetic analyses of 26 families of transport systems that either had not been characterized previously or were in need of updating. Among the families analyzed are some that are bacterial-specific, others that are eukaryotic-specific, and others that are ubiquitous. They can function by either a channel-type or a carrier-type mechanism, and in the latter case, they are frequently energized by coupling solute transport to the flux of an ion down its electrochemical gradient. We tabulate the currently sequenced members of the 26 families analyzed, describe the properties of these families, and present partial multiple alignments, signature sequences and phylogenetic trees for them all.

Amino Acid Sequence↗

PubMed1999

Psychometric aspects of verbal pragmatic ratings.

This study examined the psychometric aspects of a verbal pragmatic rating scale. The scale contained six pragmatic features (i.e., Conciseness, Lexical Selection, Quantity, Relevancy, Specificity, and Topic Maintenance) based on Grice's cooperative principles. Fifteen right brain-damaged (RBD), 15 left brain-damaged (LBD), and 16 healthy normal control (NC) right-handed adult participants produced narratives while recollecting emotional and nonemotional experiences. Naive raters evaluated each pragmatic feature for appropriateness on a 5-point Likert scale. When reliability was examined, the overall internal consistency of the pragmatic scale was extremely high (alpha =.96). Factor analysis was conducted to examine the theoretical relations among the six pragmatic features. Three meaningful factors involving discourse content, conceptual unity, and parsimony were identified. Findings are discussed in light of Grice's model and the construct validity of the scale.

Aged↗

PubMed1999

Neuropsychologic outcome after deep hypothermic circulatory arrest in adults.

INTRODUCTION: Pediatric patients undergoing prolonged periods of deep hypothermic circulatory arrest have been found to experience long-term deficits in cognitive function. However, there is limited information of this type in adult patients who are undergoing deep hypothermic circulatory arrest for thoracic aortic repairs. METHODS: One hundred forty-nine patients undergoing elective cardiac or thoracic aortic operations were evaluated preoperatively; 106 patients were evaluated early in the postoperative period (EARLY), and 77 patients were evaluated late in the postoperative period (LATE) with a battery of neuropsychologic tests. Seventy-three patients had routine cardiac operations without deep hypothermic circulatory arrest, and 76 patients with deep hypothermic circulatory arrest were divided into 2 subgroups: those with 1 to 24 minutes of deep hypothermic circulatory arrest (n = 36 patients) and those with 25 minutes or more of deep hypothermic circulatory arrest (n = 40 patients). The neuropsychologic test battery consisted of 8 tests encompassing 5 domains: attention, processing speed, memory, executive function, and fine motor function. Data were normalized to baseline values, and changes from baseline were analyzed by analysis of covariance, multivariate logistic regression, and survival functions. RESULTS: In all domains, poor performance or inability to be tested EARLY were significant predictors of poor performance LATE (odds ratio, 5.27; P <.01). Deep hypothermic circulatory arrest of 25 minutes or more and advanced age were significant predictors of poor performance LATE for the memory and fine motor domains. Deep hypothermic circulatory arrest of 25 minutes or more (odds ratio, 4. 0; P =.02) was a determinant of prolonged hospital stay (>21 days). CONCLUSION: Deep hypothermic circulatory arrest of 25 minutes or more and advanced age were associated with memory and fine motor deficits and with prolonged hospital stay.

Age Factors↗

PubMed1999

Cross-sectional and longitudinal relationships among age, cognition, and processing speed.

Cross-sectional and longitudinal age effects on cognitive function were examined in 302 older adults followed longitudinally. Processing speed was related to cognitive performance at cross-section, and change in speed predicted within-person longitudinal cognitive decline. Statistical control of processing speed greatly reduced cross-sectional age effects but did not attenuate longitudinal aging effects. This difference in processing speed's ability to account for cross-sectional and longitudinal age effects is discussed in the context of theories of cognitive aging and methodological and statistical issues pertaining to the cross-sectional and longitudinal study of cognitive aging.

Age Factors↗

PubMed1999

The effects of age and gender on the perception of lexical emotion.

The primary purpose of this study was to examine the perception of lexical/verbal emotion across the adult life span. Secondary goals were to examine the contribution of gender and valence (i.e., pleasantness/unpleasantness) to the processing of lexical emotional stimuli. Participants were 28 young (ages 20-39), 28 middle-aged (ages 40-59), and 28 older (ages 60-85) right-handed adults; there were 14 men and 14 women in each age group. Age groups were comparable on demographic and cognitive variables. Participants made accuracy judgments and intensity ratings of emotional (both positive and negative) and nonemotional stimuli from lexical perception tasks from the New York Emotion Battery (Borod, Welkowitz, & Obler, 1992). Accuracy and intensity measures were not significantly correlated. When age was examined, older participants perceived emotional and nonemotional lexical stimuli with significantly less accuracy than did younger and middle-aged participants. On the other hand, older participants evaluated the nonemotional lexical stimuli as significantly more intense than younger participants. When gender was examined, lexical stimuli were processed more accurately by female than male participants. Further, emotional stimuli were rated more intense by female participants. Clinical implications of these findings are discussed.

Adult↗

PubMed1999

Cognitive processing speed in Lyme disease.

OBJECTIVE: The goal of this study was to more precisely define the nature of the cognitive processing deficits in the patients with Lyme disease. BACKGROUND: Lyme disease has been associated with cognitive disturbances. METHOD: Sixteen patients who met the Centers for Disease Control's case definition for Lyme disease and 15 age- and education-matched control subjects completed two computerized assessments. The first was a matching procedure that assessed perceptual/motor speed. The second task was an alphabet-arithmetic (AA) test that measured the speed of mental arithmetic. On the matching task, subjects judged as true or false simple identity equations (e.g., B + 0 = B). On the AA task, subjects indicated the veracity of equations of the same form as those of the matching task but which required mental arithmetic (e.g., A + 3 = D). The use of this paradigm permits sensory or motor slowing to be distinguished from slowed cognitive processing speed. Also, the tests do not involve automated or overlearned responses. RESULTS: Lyme disease patients and healthy controls did not differ in perceptual/motor speed. However, Lyme disease patients' response times were significantly longer than those of healthy controls during the AA task, demonstrating specific impairments in mental activation speed. CONCLUSIONS: These results suggest that Lyme disease patients show specific deficits when initiating a cognitive process. These impairments are independent of sensory, perceptual, or motor deficits.

Adult↗

PubMed1998

Demographic influences on free and cued selective reminding performance in older persons.

This study evaluated the influence of age, gender, race, and education on learning and memory in older persons. Free and Cued Selective Reminding (FCSR) was administered to a community-based sample of 216 Caucasian and 50 African American seniors as part of a larger medical and neuropsychological battery. Although age, education, and gender influenced FCSR performance, race did not. The study suggests that memory performance is not influenced by race and that race-adjustment may not be necessary in the norming of memory tests.

Black or African American↗

PubMed1998

Cognitive and affective functioning in Parkinson's disease patients with lateralized motor signs.

Eleven patients with Parkinson's disease (PD) and predominantly right-sided motor signs, 12 patients with PD and predominantly left-sided signs, and 11 demographically matched healthy controls were compared on tests assessing a range of cognitive and affective functions. Assuming a novel approach, our test battery was composed of measures drawn from ones previously used in the hemiparkinson' s disease and lateralized PD literature. The two patient groups were similar in illness duration, severity of motor signs, and degree of lateralized motor deficits. Statistical analyses did not reveal significant differences between patient groups, consistent with other studies that have failed to find differences in neuropsychological functioning between PD patients with right- and left-sided motor signs.

Affect↗

PubMed1998

The Beck Depression Inventory: is it a suitable measure of depression for individuals with traumatic brain injury?

OBJECTIVE: This study examined the relationship between Beck Depression Inventory (BDI) scores and current diagnosis of depression, based on The Structured Clinical Interview for DSM-IV Diagnosis (SCID). DESIGN: Correlation. SETTING: Community-based sample. PARTICIPANTS: 100 individuals with traumatic brain injury (TBI) participated in this study, 25 of whom were diagnosed as depressed and 75 as not depressed at the time of interview. MAIN OUTCOME MEASURES: BDI scores, number of symptoms reported on a symptom checklist and DSM-IV diagnosis of depression. RESULTS: BDI symptoms correlated significantly with the SCID diagnosis of depression (r = .30) but were more strongly related (r = .67) to the number of non-depression-related problems reported, using the TIRR Symptom Checklist, a list of symptoms frequently found post TBI. The BDI had low sensitivity for discriminating depressed from nondepressed individuals (sensitivity = 36% when specificity was set at 80%). These results suggest that for individuals with TBI, high BDI scores may reflect hyperreactivity to post-TBI symptoms to a greater extent than clinical depression. CONCLUSIONS: Further study is needed to (1) understand the physiological, functional, and psychosocial factors that are associated with depression in individuals with TBI; (2) provide the basis for developing better measures of depression; and (3) understand how depression is experienced after TBI.

Adult↗

PubMed1998

Undiagnosed health issues in individuals with traumatic brain injury living in the community.

OBJECTIVES: To examine the self-reported prevalence of long-term health issues in individuals with traumatic brain injury (TBI) living in the community. DESIGN: A structured health interview. For individuals with TBI, the presence of a specific health-related issue with onset post-TBI and currently a problem at the time of the interview was explored. For individuals without disability, a specific health-related issue was evaluated at time of interview. For each health issue, the proportion of individuals with TBI experiencing post-TBI onset but current symptoms was contrasted with symptom reports of individuals without disability. Chi-square statistical analyses were used to determine significance. For individuals with TBI, logistic regressions were used to model the probability of having a particular health difficulty when four covariates were examined, such as age, gender, time since onset of TBI, and duration of loss of consciousness (LOC). SETTING: Urban, suburban, and rural New York State. PARTICIPANTS: 338 individuals with TBI and 273 individuals without disability between the ages of 18 and 65 years. Individuals with TBI were, on average, 10 years post-onset at the time of interview. MAIN OUTCOME MEASURES: Self-reported health issues reflective of neuroendocrine, neurological, immunosuppression, and other health issues. RESULTS: Chronic health issues suggestive of ongoing neuroendocrine dysfunctions (ie, changes in hair/skin texture, body temperature changes), neurologic difficulties (ie, headaches, seizures, balance difficulties, spasticity, sleep disturbances, loss of urinary control), and arthritic complaints were significantly more common in individuals with TBI. The prevalence of many of these health-related difficulties was related to duration of LOC but not to time since injury. Age and gender effects were found, with older women with TBI more likely to report thyroid conditions, sleep disturbances, loss of urinary control, and arthritic changes. Women also reported greater frequency of headaches, colds, weight changes, and temperature changes post TBI. CONCLUSION: Health issues reflective of neuroendocrine, neurological, and arthritic difficulties are common long-term health issues for individuals with TBI. Proactive patient education, ongoing health screening with appropriate medical follow-up, and timely interventions for individuals with TBI are indicated. Longitudinal studies are necessary to examine the natural course of post-TBI health difficulties.

Adolescent↗

PubMed1998

The benefits of exercise in individuals with traumatic brain injury: a retrospective study.

OBJECTIVE: This study examined the benefits of exercise. DESIGN: A retrospective study. SETTING: A community-based sample. PARTICIPANTS: A sample of 240 individuals with traumatic brain injury (TBI) (64 exercisers and 176 nonexercisers) and 139 individuals without a disability (66 exercisers and 73 nonexercisers). MAIN OUTCOME MEASURES: Scales measuring disability and handicap. RESULTS: It was found that the TBI exercisers were less depressed than nonexercising individuals with TBI, TBI exercisers reported fewer symptoms, and their self-reported health status was better than the nonexercising individuals with TBI. There were no differences between the two groups of individuals with TBI on measures of disability and handicap. CONCLUSIONS: The findings suggest that exercise improves mood and aspects of health status but does affect aspects of disability and handicap.

Adolescent↗

PubMed1998

The effect of employment on quality of life and community integration after traumatic brain injury.

OBJECTIVES: To investigate the effect of employment on perceived quality of life (QOL), social integration, and home and leisure activities for individuals with traumatic brain injuries (TBIs). DESIGN: A number of demographic and injury-related variables (age at injury, time since injury, severity of injury, education, gender, preinjury household income, and marital status) were analyzed for their association first with employment and then with the QOL, social integration, and home and leisure activities. Any of these variables showing significant associations were then included along with level of employment in three final multivariate analyses of variance (MANOVAs), again predicting QOL, social integration, and home and leisure activities. SETTING: Urban, suburban, and rural New York state. PARTICIPANTS: 337 adults with TBI who resided in New York state and were between the ages of 18 and 65 years. MAIN OUTCOME MEASURES: The Craig Handicap Assessment Capacity Technique, the Bigelow Quality of Life Questionnaire, the Flanagan Scale of Needs (adapted), and a global QOL measure. RESULTS: Employment showed a strong and consistent relationship with perceived QOL, social integration within the community, and home and leisure activities. Part-time employment may have been superior to full-time employment for individuals with TBI: part-time workers had fewer unmet needs, were more socially integrated, and were more engaged in home activities than full-time workers. Loss of consciousness, as a measure of severity, was unexpectedly predictive of diminished sense of QOL for individuals with less severe injuries. CONCLUSIONS: Being employed contributes to one"s sense of well-being, social integration, and pursuit of leisure and home activities. Select advantages of working part-time for individuals with TBI were identified.

Adolescent↗

PubMed1998

The enigma of "hidden" traumatic brain injury.

OBJECTIVE: To examine individuals with "hidden" traumatic brain injury (TBI), defined in this study as those who sustained a blow to the head, with altered mental status, and experienced a substantial number of the cognitive, behavioral, and emotional sequelae typically associated with brain injury but did not make the causal connection between the injury and its consequences. DESIGN: Comparison of four groups of individuals matched for age, gender, years of education, and duration of loss of consciousness. SETTING: This study of hidden TBI followed the identification of 143 individuals who, within a larger study of people with TBI who live in the community, identified themselves as "nondisabled" (they were to be part of the comparison sample) but who had experienced a blow to the head that left them at minimum dazed and confused. PARTICIPANTS: 21 of these 143 individuals also reported large numbers of symptoms (eg, headaches, memory problems) associated with TBI. This group (Hidden TBI-High Symptoms group) was compared to three other matched samples: one with known TBI (Known Mild TBI group) and one with no disability (No Disability group) (both of which were drawn from the larger study), and one group of individuals who identified themselves as having no disability but who had experienced a blow to the head that resulted in a few symptoms (Head Trauma-Low Symptoms group). MAIN OUTCOME MEASURES: All study participants were administered an interview that incorporated several existing instruments documenting levels of reported symptoms, emotional well-being/distress, and vocational/social handicaps. RESULTS: The Hidden TBI-High Symptoms group was found to be similar to the Known Mild TBI group in terms of the number and types of symptoms experienced, whereas the Head Trauma-Low Symptoms group was similar in this respect to the No Disability group. The two former groups also evidenced high levels of emotional distress, whereas the two latter groups did not. However, on measures of handicap, the Hidden TBI-High Symptoms and Head Trauma-Low Symptoms groups were similar to the No Disability group and dissimilar from the Known Mild TBI group in that the last group experienced vocational handicap, in particular, whereas the other groups did not. CONCLUSIONS: We conclude that hidden TBI occurs at a nontrivial level (7% of our nondisabled sample). Also, individuals with hidden TBI (with persistent symptoms), unlike those with known mild TBI, are likely to experience emotional distress but not vocational handicap following injury.

Adult↗

PubMed1997

Aging and counting speed: evidence for process-specific slowing.

The performance of adults ranging in age from 20 to 86 on two nonlexical tasks that required different types of counting operations was examined. Subproportional age effects for incrementing speed and for enumeration speed (counting 5 to 8 items) indicate that some types of counting processes are exempt from the slowing effects of aging. Increased age was associated with a diminished frequency and slowing of subitizing (counting < or = 4 items) as well as with slowing in the speed of initiating the incrementing process, but the course of age-related slowing for these measures is described by different functions. These results indicate that cognitive slowing is not equivalent for different types of processes involved in counting and numerosity judgments.

Adult↗

PubMed1997

Processing speed and memory in aging and dementia.

We examined the role of processing speed (PS) as a mediator of age-related and dementia-related differences in cued recall and text memory. Consistent with previous research, statistical control of PS significantly attenuated or eliminated age differences on each of the memory measures. However, age-related decline in the ability to benefit from conditions of increased encoding specificity was not mediated by PS. In contrast to the results for age effects, statistical control of PS did not significantly attenuate dementia-related memory differences, suggesting that processing speed is not an important dementia-related memory impairment. The implications of these findings for interpreting residual age effects and the possible influence of preclinical dementia on studies of normal aging are discussed.

Adolescent↗