Biomedical subjects
Publications and source records attributed to Patricio S Espinosa.
We describe a 81-year-old man who after falling face forward and hyperextending his neck suffer an acute cervical spinal cord injury consistent with acute traumatic central cord syndrome (ATCCS) who developed a peculiar posture with arm abduction at the shoulders and flexion at the elbows and wrists resembling the pose of a bodybuilder.
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OBJECTIVE: Larger brains may contain more neurons and synaptic connections, providing a greater reserve against cognitive decline in Alzheimer's disease (AD). Larger head circumference (HC) may therefore be associated with later detection and diagnosis of AD. We investigated HC in nondemented individuals and AD patients using cross-sectional and prospective analyses. METHODS: The cross sectional analysis compared mean HC between 592 AD patients and 459 nondemented controls. Prospective analysis was based on the same initially normal controls who were followed longitudinally for conversion to dementia. Diagnosis of AD was made by neurologists using NINDS-ADRDA criteria. RESULTS: When compared to AD patients, controls had a significantly larger mean HC by 0.58 cm in men and by 0.31 cm in women, but these differences were no longer significant after adjustment for age and years of education. HC varied inversely with age and directly with years of education but did not vary with presence/absence of dementia in first-degree relatives or with apolipoprotein-E (ApoE) genotype. In the prospective analysis, the hazard ratio for time to conversion to AD was not significant for HC when adjusted for age at entry, ApoE allele status, family history of dementia, gender, and years of education. ApoE allele status, first degree relative with dementia, and baseline age conferred an increased risk for conversion to AD, consistent with other studies. CONCLUSIONS: We observed a smaller HC in AD patients compared to nondemented individuals, but AD per se accounted for little of this difference. HC was not a statistically significant predictor for conversion to AD in our longitudinal group.
Quit and Win smoking cessation incentive programs have been used to promote community-based smoking cessation in the United States and internationally. The Quit and Win contest has been offered annually by the Lexington-Fayette County Health Department since 2001. In order to engage in continuous quality assessment of the Quit and Win program, demographic analysis of program participants is critical to better extend the marketing message to target audiences. The goal of this analysis is to report various baseline parameters of the 2003 Lexington-Fayette County Quit and Win contest cohort. Of the 876 participants, most were white, had at least a high school education, smoked cigarettes for more than 10 years, and had multiple previous quit attempts. Most anticipated using nicotine replacement products to aid the current quit attempt. The demographic information from this analysis can be used to design future programs that target a wider segment of the population.
Although amyotrophic lateral sclerosis and progressive spinal muscular atrophy have been recognized to occur in association with human immunodeficiency virus infection, to our knowledge, brachial amyotrophic diplegia, a form of segmental motor neuron disease, has not been previously reported. Brachial amyotrophic diplegia results in severe lower motor neuron weakness and atrophy of the upper extremities in the absence of bulbar or lower extremity involvement, pyramidal features, bowel and bladder incontinence, and sensory loss. We describe a human immunodeficiency virus-seropositive man without severe immunosuppression or prior AIDS-defining illnesses who had brachial amyotrophic diplegia. This disorder may represent one end of a spectrum of motor neuron diseases occurring with this retrovirus infection.