Publications by authors named "Marra C"

Background: : To determine how serious a confound substance use (SU) might be in studies on HIV-associated neurocognitive disorder (HAND), we examined the relationship of SU history to neurocognitive impairment (NCI) in participants enrolled in the Central Nervous System HIV Antiretroviral Therapy Effects Research study.

Methods: : After excluding cases with behavioral evidence of acute intoxication and histories of factors that independently could account for NCI (eg, stroke), baseline demographic, medical, SU, and neurocognitive data were analyzed from 399 participants. Potential SU risk for NCI was determined by the following criteria: lifetime SU Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis, self-report of marked lifetime SU, or positive urine toxicology.

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Unlabelled: To determine whether the health and cost benefits of resistance training were sustained 12 months after formal cessation of the intervention.

Design: Cost-utility analysis conducted alongside a randomized controlled trial.

Setting: Community-dwelling women aged 65 to 75 living in Vancouver, British Columbia.

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Copper based-pesticides are widely used in agricultural practice throughout the world. We studied the (i) concentration of Cu and proteins involved in Cu homeostasis, (ii) plasma redox status, and (iii) biomarkers of exposure in Cu-based pesticide applicators in order to compare them with clinical biochemical tests. Thirty-one professional applicators and 32 control subjects were recruited.

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In the study of prosopagnosia, several issues (such as the specific or non-specific manifestations of prosopagnosia, the unitary or non-unitary nature of this syndrome and the mechanisms underlying face recognition disorders) are still controversial. Two main sources of variance partially accounting for these controversies could be the qualitative differences between the face recognition disorders observed in patients with prevalent lesions of the right or left hemisphere and in those with lesions encroaching upon the temporo-occipital (TO) or the (right) anterior temporal cortex. Results of our review seem to confirm these suggestions.

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Background: Asthma is difficult to diagnose in children and at times misdiagnosis of an infection can occur. However, little is known about the magnitude and patterns of antibiotic consumption in children with asthma relative to those without asthma.

Methods: Using population-based data, 128,872 children were identified with at least 6 years of follow-up.

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Despite the widening use of combination antiretroviral therapy (ART), neurocognitive impairment remains common among HIV-infected (HIV+) individuals. Associations between HIV-related neuromedical variables and magnetic resonance imaging indices of brain structural integrity may provide insight into the neural bases for these symptoms. A diverse HIV+ sample (n = 251) was studied through the CNS HIV Antiretroviral Therapy Effects Research initiative.

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This study investigates the differential contribution of gray matter (GM) atrophy and deafferentation through white matter (WM) damage in the clinical progression of Alzheimer's disease (AD). Thirty-one patients with probable AD, 23 with amnestic mild cognitive impairment (a-MCI), and 14 healthy subjects underwent MRI scanning at 3T. Voxel-based morphometry was used to assess regional GM atrophy in AD and a-MCI patients.

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Copper is dangerous when it is present in excess, mainly because it can participate in the Fenton reaction, which produces radical species. As a consequence of copper pollution, people are involuntarily exposed to a copper overload under sub-clinical and sub-symptomatological conditions, which may be very difficult to detect. Thus, we investigated (i) the possible use of the chelator molecules carnosine and neocuproine to prevent the Cu overload-induced damage on cellular lipids and proteins, as tested in human cell culture systems, and (ii) the differential response of these two chelating agents in relation to their protective action, and the type of copper ion involved in the process, by using two types of human cultured cells (HepG2 and A-549).

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Background: The association between lower socioeconomic status and poorer health outcomes has been observed using both individual-level and aggregate-level measures of income and education. While both are predictive of health outcomes, previous research indicates poor agreement between individual-level and aggregate-level measures. The purpose of this study was to determine the level of agreement between aggregate-level and individual-level measures of income and education among three distinct patient groups, specifically asthma, diabetes, and rheumatoid patients.

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Background: falls-related self-efficacy is associated with falls, falls-related injury and subsequent functional decline which may lead to poor health-related quality-of-life (HRQL). To our knowledge, no previous studies have examined the independent contribution of falls-related self-efficacy to HRQL. Our primary objective was to determine whether falls-related self-efficacy is independently associated HRQL, measured by quality-adjusted life years (QALYs), in older women after accounting for known covariates.

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Objectives: The purpose of this pilot study was to evaluate the efficacy of acupuncture in relieving perineal pain after mediolateral episiotomy during childbirth.

Design And Subjects: Women with mediolateral episiotomy during delivery were enrolled in this study and were assigned to be treated or not with acupuncture.

Outcomes Measures: Perineal pain relieving effect of acupuncture was evaluated considering oral analgesics request during post-partum period and was the main outcome of this trial.

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Rheumatoid arthritis (RA) is a chronic, debilitating inflammatory, progressive musculoskeletal disease that affects 0.5-1.0% of the adult population in Western countries.

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Objective: To evaluate patients' preferences for various attributes of insulin treatment, including route of insulin delivery.

Methods: We used a discrete choice experiment (DCE) to quantify patients' preferences. The attributes (and levels) included in the DCE questionnaire were: glucose control, frequency of hypoglycemic events, weight gain, route of administration for the long-acting and the short-acting insulin, and out-of-pocket cost.

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Extra-virgin olive oil is an integral ingredient of the Mediterranean diet, and it has been suggested that its high consumption has beneficial effects on human health. Its protective effect, in particular against the development of CVD, has been related not only to the high content of oleic acid, but also to the antioxidant and anti-inflammatory properties of polyphenols. In order to verify the anti-inflammatory and anti-atherogenic properties of hydroxy-isochromans, a class of ortho-diphenols present in extra-virgin olive oil, we investigated the potential ability of 1-phenyl-6,7-dihydroxy-isochroman (L137) to modulate the production of key inflammatory mediators by human monocytes, by evaluating its in vitro effects on prostanoid (thromboxane A(2) and PGE(2)) and cytokine (TNF-α) production.

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Interleukin-2 (IL-2), a prototypical pro-inflammatory cytokine firstly related to T cells differentiation, exerts pleiotrophic functions in several areas of the central nervous system. Previously we had described the neurotrophic roles of this interleukin upon retinal neurons. Therefore, the aim of this work was to investigate the signaling pathways involved in the neuroprotective effect of IL-2 on axotomized RGC.

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We explored the possible augmenting effect of traumatic brain injury (TBI) history on HIV (human immunodeficiency virus) associated neurocognitive complications. HIV-infected participants with self-reported history of definite TBI were compared to HIV patients without TBI history. Groups were equated for relevant demographic and HIV-associated characteristics.

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Cognitive reserve (CR), for which formal education represents a proxy index, has been claimed as a factor mitigating the clinical manifestations of Alzheimer disease (AD). The aim of this study was to assess the impact of formal education in modifying the relationship between cerebral grey matter (GM) damage and clinical manifestations in a large cohort of patients with AD or amnesic mild cognitive impairment (a-MCI). We recruited 22 patients with AD and 23 with a-MCI, and we classified them in subjects with high (HEL) or low educational level (LEL).

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Combination antiretroviral therapy (CART) has greatly reduced medical morbidity and mortality with HIV infection, but high rates of HIV-associated neurocognitive disorders (HAND) continue to be reported. Because large HIV-infected (HIV+) and uninfected (HIV-) groups have not been studied with similar methods in the pre-CART and CART eras, it is unclear whether CART has changed the prevalence, nature, and clinical correlates of HAND. We used comparable methods of subject screening and assessments to classify neurocognitive impairment (NCI) in large groups of HIV + and HIV - participants from the pre-CART era (1988-1995; N = 857) and CART era (2000-2007; N = 937).

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Background And Purpose: Subtle linguistic dysfunction and reorganization of the language network were described in patients with epilepsy, suggesting the occurrence of plasticity changes. We used resting state FC-MRI to investigate the effects induced by chronic epilepsy on the connectivity of the language-related brain regions and correlated it with language performance.

Materials And Methods: FC-MRI was evaluated in 22 right-handed patients with drug-resistant epilepsy (11 with LE and 11 with RE) and in 12 healthy volunteers.

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Objectives: This is a cross-sectional, observational study to determine the frequency and associated features of HIV-associated neurocognitive disorders (HAND) in a large, diverse sample of infected individuals in the era of combination antiretroviral therapy (CART).

Methods: A total of 1,555 HIV-infected adults were recruited from 6 university clinics across the United States, with minimal exclusions. We used standardized neuromedical, psychiatric, and neuropsychological (NP) examinations, and recently published criteria for diagnosing HAND and classifying 3 levels of comorbidity (minimal to severe non-HIV risks for NP impairment).

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With the rising incidence and prevalence of syphilis, meningovascular syphilis and other forms of neurosyphilis have reappeared, particularly among persons infected with human immunodeficiency virus. We present a patient with meningovascular syphilis leading to stroke after treatment with penicillin and antiretroviral therapy.

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Background: Granting dispensing pharmacists the authority to prescribe has significant implications for pharmaceutical and health human resources policy, and quality of care. Despite the growing number of jurisdictions that have given pharmacists such privileges, there are few rigorous evaluations of these policy changes. This study will examine a January 2009 policy change in British Columbia (BC), Canada that allowed pharmacists to independently adapt and renew prescriptions.

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Background: Mobile (cell) phone communication has been suggested as a method to improve delivery of health services. However, data on the effects of mobile health technology on patient outcomes in resource-limited settings are limited. We aimed to assess whether mobile phone communication between health-care workers and patients starting antiretroviral therapy in Kenya improved drug adherence and suppression of plasma HIV-1 RNA load.

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