Goal-oriented cognitive rehabilitation for early-stage Alzheimer's and related dementias: the GREAT RCT.

Background: Cognitive rehabilitation (CR) is an individualised, person-centred intervention for people with mild to moderate dementia that addresses the impact of cognitive impairment on everyday functioning.

Objectives: To determine whether or not CR is a clinically effective and cost-effective intervention for people with mild to moderate Alzheimer's disease or vascular or mixed dementia, and their carers.

Design: This multicentre randomised controlled trial compared CR with treatment as usual (TAU).

Individual goal-oriented cognitive rehabilitation to improve everyday functioning for people with early-stage dementia: A multicentre randomised controlled trial (the GREAT trial).

Objectives: To determine whether individual goal-oriented cognitive rehabilitation (CR) improves everyday functioning for people with mild-to-moderate dementia.

Design And Methods: Parallel group multicentre single-blind randomised controlled trial (RCT) comparing CR added to usual treatment (CR) with usual treatment alone (TAU) for people with an ICD-10 diagnosis of Alzheimer, vascular or mixed dementia, and mild-to-moderate cognitive impairment (Mini-Mental State Examination [MMSE] score ≥ 18), and with a family member willing to contribute. Participants allocated to CR received 10 weekly sessions over 3 months and four maintenance sessions over 6 months.

Chronic inflammation masquerading as an appendiceal tumour with peritoneal metastasis: the challenge of diagnosis and the lessons learnt.

Advanced radiological imaging has largely replaced exploratory operations and has become an essential diagnostic tool clinicians routinely rely on. However, physicians are faced with a lot of radiological findings without histological proof, and assuming a more serious diagnosis may lead to unnecessary investigations and emotional stress for patients. We report an unusual presentation of chronic appendicitis with a synchronous peritoneal nodule on CT in a 76-year-old woman who presented with poor appetite, weight loss and a mass in the right iliac fossa.

Museum activities in dementia care: Using visual analog scales to measure subjective wellbeing.

Introduction Previous research has shown that people with dementia and caregivers derive wellbeing-related benefits from viewing art in a group, and that facilitated museum object handling is effective in increasing subjective wellbeing for people with a range of health conditions. The present study quantitatively compared the impact of two museum-based activities and a social activity on the subjective wellbeing of people with dementia and their caregivers. Methods A quasi-experimental crossover design was used.

Clostridium difficile infection after ileostomy closure mimicking anastomotic leak.

Clostridium difficile infection is linked to antibiotic exposure, with elderly and immunocompromised hospitalised patients being particularly at risk. The symptoms range from mild diarrhoea to life-threatening fulminant colitis. We describe an unusual presentation of C.

Variation in referral practice for patients with colorectal cancer liver metastases.

Background: Half of patients with colorectal cancer develop liver metastases. There remains great variability between hospitals in rates of liver resection for colorectal cancer liver metastases (CLM). This study aimed to determine how many patients with potentially resectable CLM are not seen by specialist liver surgeons.

Diffusion-weighted MRI of the liver-Interpretative pearls and pitfalls.

Diffusion-weighted magnetic resonance imaging (DW MRI) is an established technique in neuroradiology and more recently has emerged as a useful adjunct to various oncological applications of MRI. It has an expanding role in the evaluation of liver lesions, offers higher detection rates for small lesions, and can increase confidence in differentiating between benign and malignant lesions. Other applications include assessment of tumour response to therapy, differentiating tumour from bland thrombus, and assessment of liver fibrosis.

Optimizing the role of FDG PET-CT for potentially operable metastatic colorectal cancer.

Recent treatment advances now allow a realistic chance of cure in selected patients with metastatic colorectal carcinoma (CRC). Accurate pre-treatment staging is crucial to ensure appropriate management by identification of patients with more advanced disease who will not benefit from surgery. (18)Fluorine 2-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography (PET-CT) has a firmly established role in staging, restaging, and recurrence detection of a range of tumors.

Patient experience, pain, and quality of life after lower limb angioplasty: a multisite prospective cohort study.

Purpose: To explore the experience of patients undergoing endovascular lower limb angioplasty and evaluate the improvements in quality of life and disease-related symptoms after the procedure.

Methods: Patients completed a questionnaire before treatment and three questionnaires after the procedure (immediately after the procedure, and again 4 weeks and 3 months later). Anxiety, patient understanding, procedure-related pain, and disease-related pain were assessed by a visual analog score (VAS).

Iliac artery occlusion with "oxbow lake" formation following stent deployment in a tortuous external iliac artery during EVAR: a case report.

In this case report, we describe a complication that we term the "oxbow lake" deformity. This phenomenon occurs when a tortuous elongated external iliac artery segment is artificially straightened by an iliac stent resulting in kinking and compression of a redundant loop with lumen compromise. We describe the anatomy, corrective treatment, and outcome.

False-positive uptake on 2-[¹⁸F]-fluoro-2-deoxy-D-glucose (FDG) positron-emission tomography/computed tomography (PET/CT) in oncological imaging.

With the increasing utilization of integrated positron-emission tomography/computed tomography (PET/CT) using the glucose analogue 2-[¹⁸F]-fluoro-2-deoxy-D-glucose (FDG) in oncological imaging, it is important for radiologists and nuclear medicine physicians to be aware that FDG uptake is not specific for malignancy, as many different physiological variants and benign pathological conditions can also exhibit increased glucose metabolism. Such false-positive FDG uptake often arises outside the area of primary interest and may mimic malignant disease, thereby confounding accurate interpretation of PET/CT studies. With the use of illustrative clinical cases, this article will provide a systematic overview of potential interpretative pitfalls and illustrate how such unexpected findings can be appropriately evaluated.

Are radiologists able to manage serious anaphylactic reactions and cardiopulmonary arrest?

In this study, we aimed to assess the ability and confidence of radiologists in managing adult life support in cardiopulmonary arrest and acute anaphylaxis reactions. We used a questionnaire survey assessing the knowledge of how to manage and the confidence in managing an adult cardiorespiratory arrest scenario. This was sent to 165 radiology consultants and registrars in 6 NHS trusts in Yorkshire: 105 participated.

Screening for dementia in primary care: a review of the use, efficacy and quality of measures.

Background: Despite evidence that early identification of dementia is of growing policy and practice significance in the U.K., limited work has been done on evaluating screening measures for use in primary care.

Congenital talipes equinovarus in Papua New Guinea: a difficult yet potentially manageable situation.

Reports in the literature have suggested a high incidence of congenital deformities, including congenital talipes equinovarus (CTEV), in many Pacific Islands. This study performed a retrospective analysis of cases of CTEV in an isolated region of Papua New Guinea over a 2-year period. Data was collected on the incidence of CTEV, together with an analysis of initial treatment and outcome.

The CORE-OM in an older adult population: psychometric status, acceptability, and feasibility.

There is a need to extend and test the feasibility and acceptability of mental health outcome measures in the older population (i.e., aged 65-100).

An examination of the relationship between cycle training, cycle accidents, attitudes and cycling behaviour among children.

Around 40% of 10-11-year-old children receive cycle training every year in the UK, but concern has been expressed over the efficacy of training courses. One argument is that accidents occur too infrequently to be a viable evaluative criterion, and attitudes and behaviour have been suggested as alternatives. A questionnaire that measured a number of variables including accidents, attitudes, and behaviour was completed by 336 participants from two schools in the London Borough of Bromley.

Convergent validity of the Agnew Relationship Measure and the Working Alliance Inventory.

The convergent validity of the Agnew Relationship Measure (ARM) and the Working Alliance Inventory (WAI) was assessed in samples drawn from 2 comparative clinical trials of time-limited psychotherapies for depression. In 1 sample, clients (n = 18) and therapists (n = 4) completed self-report versions of both measures after every session (n = 198). In the other sample, clients (n = 39) and therapists (n = 6) completed the ARM, and observers subsequently rated selected audiotaped sessions (n = 78) using the WAI.

Pragmatic randomized trial of antenatal intervention to prevent post-natal depression by reducing psychosocial risk factors.

Background: Social support theory and observational risk factor studies suggest that increased antenatal psychosocial support could prevent post-natal depression. We used empirical knowledge of risk and protective factors for post-natal depression not employed previously in order to develop and evaluate an antenatal preventive intervention.

Methods: We conducted a pragmatic randomized controlled trial in antenatal clinics.

Outcomes of time-limited psychotherapy in applied settings: replicating the Second Sheffield Psychotherapy Project.

In a replication and extension of the Second Sheffield Psychotherapy Project (SPP2), a collaborative psychotherapy project (CPP) was carried out at 3 sites within the National Health Service of the United Kingdom. Clients (N = 36) stratified at 3 levels of severity of depression were randomly assigned to one of 2 treatment approaches (psychodynamic-interpersonal or cognitive-behavioral) of 2 time-limited durations (8 or 16 sessions). Gains in both treatment approaches were approximately equivalent and were similar for CPP and SPP2 clients when measured at the end of treatment.

Tissue-specific expression of neural cell adhesion molecule (NCAM) may allow differential diagnosis of neuroblastoma from embryonal rhabdomyosarcoma.

The MSD1 region of neural cell adhesion molecule (NCAM) was originally described as being spliced into the 120-kDa isoform of NCAM isolated from muscle. The 105 bp region is inserted between exons 12 and 13 and actually consists of three separate exons, MSD1a, MSD1b and MSD1c of 15, 48, 42 bp, respectively. In addition, a further exons consisting of a single triplet has been designated MSD1d, making the full insert size 108 bp.

Vase mini-exon usage by NCAM is not restricted to tumours of neuroectodermal origin.

The neural cell adhesion molecule (NCAM) plays an important role in normal development. Many variants of NCAM are generated through post-transcriptional and post-translational modifications. These variants are tissue-specific and their expression is developmentally regulated.

The California Psychotherapy Alliance Scales: a pilot study of dimensions and elements.

The reliability and clinical utility of the rater form of the California Psychotherapy Alliance Scales (CALPAS-R) was investigated on a sample of 12 one-hour audiotapes representing differing therapeutic dyads and sampled from sessions two to six of a relationship-oriented (exploratory) therapy within pilot cases of a large outcome study. Both global dimensions and element-based ratings were used to test the feasibility of employing the elements as a way of obtaining a finer-grained analysis of the therapeutic alliance. Results are reported in terms of the interrater reliability of the dimensions and elements, and show element ratings to yield dimensional measures similar or superior to global ratings in reliability.

Splicing of the VASE exon of neural cell adhesion molecule (NCAM) in human small-cell lung carcinoma (SCLC).

Expression of the neural cell adhesion molecule (NCAM) on small-cell lung carcinoma (SCLC) cell lines and tumour tissue has been investigated. Cell lines were found to express highly sialylated NCAM. Neuraminidase treatment revealed the presence of the 140- and 120-kDa isoforms with differential expression of a 95-kDa protein.