Cerebrovascular Pathophysiology in Preeclampsia and Eclampsia
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Recent theories of addictive behaviors suggest that neurocognitive mechanisms, such as attentional processing, cognitive control, and reward processing play a role in the maintenance or development of addiction. Several studies will be discussed demonstrating the role of these neurocognitive mechanisms in addiction. Moreover, clinical issues such as the feasibility to use neurocognitive measures as predictor of treatment success and relapse will be discussed.
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Neurocognitive assessment plays a central role in the diagnosis of human immunodeficiency virus- (HIV) associated neurocognitive disorders (HAND). The history of diagnostic categories and labeling of HIV-related neurological disorders is briefly presented. The current diagnostic nomenclature of HAND and the role of neurocognitive assessment is examined. Though neurocognitive testing is sensitive in assessing a broad range of cognitive impairments, neurocognitive testing is not specific to HAND without consideration of the impact on functional status, as well as confounding factors, including premorbid status.
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Individuals at clinical high risk for psychosis (CHR) exhibit neurocognitive deficits in multiple domains. The aim of this study is to investigate whether several components of neurocognition are predictive of conversion to psychosis.Fifty-two CHR individuals were assessed with the Structured Interview for Psychosis Risk Syndromes and completed a battery of neurocognitive tests at baseline including measures of executive functioning, attention, working memory, processing speed and reaction time. Neurocognitive functioning at baseline was scored based on an external normative control group. Most subjects were followed for 2.5 years to determine conversion status.Significant differences in neurocognitive functioning between CHR individuals and the control group were present in all domains. Twenty-six per cent of the participants converted to psychosis within 9.8 (standard deviation = 8.0) months on average (median 9 months), but there were no significant differences in neurocognition converters and non-converters.Individuals at CHR have deficits in neurocognitive functioning, but such deficits do not appear to be related to conversion risk.
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HIV infection is associated with disturbances in brain function which reflect themselves in HIV associated neurocognitive disorder (HAND). Neurocognitive examination is a sensitive and relevant approach to detecting and monitoring HAND. The approaches to evaluating the various neurocognitive disturbances are reviewed, along with consideration of cofactors that may influence expression of these disorders.
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Background: Women with history of preeclampsia have reportedly higher risk of development of preeclampsia in subsequent pregnancies, along with other adverse pregnancy outcomes. Authors aimed to study the incidence of recurrent preeclampsia and compare the pregnancy outcome in women with history of preeclampsia in previous pregnancy with those who were normotensive in previous pregnancy and further compare outcomes in women with recurrent preeclampsia between their previous and index pregnancy.Methods: Pregnancy outcome was studied in women with preeclampsia in previous pregnancy (cases) and compared with women normotensive in previous pregnancy (controls). Further analysis of cases was done by dividing them into subgroups: those with recurrent preeclampsia in index pregnancy (A1) and those normotensive in index pregnancy despite being pre-eclamptic in previous pregnancy (A2). Total 100 cases and 100 controls were enrolled in the study, which was conducted at present tertiary care centre from January 2012 to June 2013.Results: Out of total 200 participants (100 cases, 100 controls) enrolled in the study; 58 out of 100 cases had recurrent preeclampsia and remaining 42 remained normo-tensive in index pregnancy. Among 100 controls, 93 were normotensive in index pregnancy.Conclusions: Women with history of preeclampsia in previous pregnancy had adverse maternal and perinatal outcome in subsequent pregnancy when compared to the women who were normotensive in the previous pregnancy. But when compared with their own previous preeclamptic pregnancy, they had better pregnancy outcome with good perinatal outcome in their index pregnancy.
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