Effects of isoflavone on the learning and memory of women in menopause: a double-blind placebo-controlled study

Hormone decline is common to all women during aging and, associated with other factors, leads to cognitive impairment. Its replacement enhances cognitive performance, but not all women present a clinical and family or personal history that justifies its use, mainly women with a history of cancer. The aim of this study was to determine whether a daily oral dose of 80 mg of isoflavone extract for 4 months can produce benefits in women with low hormone levels, contributing to improvement in cognitive aspects. The sample comprised 50- to 65-year-old women whose menstruation had ceased at least 1 year before and who had not undergone hormone replacement. The volunteers were allocated to two groups of 19 individuals each, i.e., isoflavone and placebo. There was a weak correlation between menopause duration and low performance in the capacity to manipulate information (central executive). We observed an increase in the capacity to integrate information in the group treated with isoflavone, but no improvement in the capacity to form new memories. We did not observe differences between groups in terms of signs and symptoms suggestive of depression according to the Geriatric Depression Scale. Our results point to a possible beneficial effect of isoflavone on some abilities of the central executive. These effects could also contribute to minimizing the impact of memory impairment. Further research based on controlled clinical trials is necessary to reach consistent conclusions.

Effects of isoflavone on the learning and memory of women in menopause: a double-blind placebo-controlled study.

Hormone decline is common to all women during aging and, associated with other factors, leads to cognitive impairment. Its replacement enhances cognitive performance, but not all women present a clinical and family or personal history that justifies its use, mainly women with a history of cancer. The aim of this study was to determine whether a daily oral dose of 80 mg of isoflavone extract for 4 months can produce benefits in women with low hormone levels, contributing to improvement in cognitive aspects. The sample comprised 50- to 65-year-old women whose menstruation had ceased at least 1 year before and who had not undergone hormone replacement. The volunteers were allocated to two groups of 19 individuals each, i.e., isoflavone and placebo. There was a weak correlation between menopause duration and low performance in the capacity to manipulate information (central executive). We observed an increase in the capacity to integrate information in the group treated with isoflavone, but no improvement in the capacity to form new memories. We did not observe differences between groups in terms of signs and symptoms suggestive of depression according to the Geriatric Depression Scale. Our results point to a possible beneficial effect of isoflavone on some abilities of the central executive. These effects could also contribute to minimizing the impact of memory impairment. Further research based on controlled clinical trials is necessary to reach consistent conclusions.

The reliability of nonreconstructed computerized tomographic scans of the abdomen and pelvis in detecting thoracolumbar spine injuries in blunt trauma patients with altered mental status.

BACKGROUND: Computerized tomography, traditionally utilized to evaluate and detect visceral abdominal and pelvic injuries in multiply injured patients with altered mental status, also has been useful for detecting thoracolumbar spine fractures and dislocations. The purpose of the present study was to test the reliability of nonreconstructed computerized tomography of the abdomen and pelvis as a screening tool for thoracolumbar spine injuries in blunt trauma patients with altered mental status. METHODS: The study consisted of fifty-nine consecutive patients with altered mental status who were admitted to a Level-II trauma center. Each patient had a nonreconstructed computerized tomographic scan of the abdomen and pelvis (5-mm slices), and of the chest when indicated, as well as anteroposterior and lateral radiographs of the thoracolumbar spine. Reconstructed computerized tomographic scans dedicated to the spine (< or =2-mm slices) were completed. With use of the reconstructions as the gold standard, sensitivity and specificity with 95% confidence intervals were calculated to assess the diagnostic accuracy of using the nonreconstructed computerized tomographic scans and the radiographs. RESULTS: Reconstructions of the spine detected seventy-two thoracolumbar spine fractures, whereas nonreconstructed computerized tomographic scans of the abdomen and pelvis detected fifty-eight and those of the chest detected sixteen. With use of the reconstructions as the standard, computerized tomography of the chest, abdomen, and pelvis had a sensitivity of 89% (95% confidence interval, 65% to 96%) and a specificity of 85% (95% confidence interval, 65% to 96%) for the detection of all fractures, compared with 37% and 76% for plain radiographs, respectively. Computerized tomography of the chest, abdomen, and pelvis was 100% sensitive and specific for the detection of whether a patient had any fracture at all, whereas radiographs were 54% sensitive and 86% specific. No fractures that were missed on nonreconstructed computerized tomography required surgery or other interventions. CONCLUSIONS: Nonreconstructed computerized tomography detected fractures of the thoracolumbar spine more accurately than plain radiographs did and is recommended for the diagnosis of thoracolumbar spine fractures in acute trauma patients with altered mental status. Reconstructions do not need to be ordered unless an abnormality that is found on the nonreconstructed computerized tomographic scan needs additional elucidation.

[The use of procedures volume indicators in an Italian Teaching Hospital]. / L'utilizzo degli indicatori di volume legati alle prestazioni. Esperienza di un Policlinico Universitario.

In a context of continuous spread health technologies, in which particular intensive procedures are performed, the use of procedure volume indicators supports the decision making process in monitoring and improving the healthcare quality. The aim of our work focuses on the evaluation of the association between the volume of procedures performed by organizational units inside an Italian University Hospital and the results in terms of mortality and prolonged length of stay (LOS). Volume indicators concerning esophageal resection, pancreatic resection, abdominal aortic aneurysm repair, coronary artery bypass graft and percutaneous transluminal coronary angioplasty were analysed according to the Agency of Health Care Research and Quality's criteria. A retrospective observational study was conducted analysing hospital discharged databases and operating room records for the period 2000-2005. Descriptive and inferential statistical analysis were performed using SPSS software 13.0 version. Regarding prolonged LOS, a statistical significant difference emerged among high and low volume organizational units for pancreatic resections, bypass, and angioplasty with respectively adjusted OR at 2.4 (C.I. 95% 1.04-5.53); 1.67 (C.I. 95% 1.29-2.16) and 3.34 (CI 95% 2.60-4.28). For mortality, a statistical significant difference emerged for abdominal aortic aneurysm repair and bypass with respectively OR at 21.02 (C.I. 95% 2.22-199.64) and 26.55 (C.I. 95% 15.30 - 46.07). The use of procedure volume indicators could help hospital administrators and medical professionals balance competing values such as control of cost and continuous quality improvement.