Neuroleptic sensitivity in dementia with cortical Lewy bodies.
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Antipsychotic Agents↗
Biomedical subjects
A Burns
Publications and source records attributed to A Burns.
Neurologic signs in Alzheimer's disease. Results of a prospective clinical and neuropathologic study.
Neurologic signs and their neuropathologic correlates were examined in a sample of 56 patients with autopsy-proved Alzheimer's disease (13 men, 43 women; mean age at death, 83.1 years; range, 67 to 96 years) from a prospective longitudinal study. Full-range regular rigidity with cog-wheeling was found in 20 patients and was significantly associated with lower neuron counts in the substantia nigra and with the presence of Lewy bodies in the brain stem and neocortex. Twelve patients with myoclonus had a younger age at onset, a lower age at death (mean, 78.6 years), and lower neuron counts in the serotoninergic dorsal raphe nucleus and in the noradrenergic locus coeruleus than did the patients without myoclonus. Generalized motor seizures were reported in six patients, and they had significantly lower counts of pyramidal cells in cortical layers III through IV of the parietal cortex (area 7) and slightly decreased pyramidal cell numbers in the parahippocampal gyrus (area 28). The 19 patients with a positive grasp reflex had an earlier onset of illness and a significantly inferior performance on the Mini-Mental State examination and Cambridge Cognitive Examination tests. They, and 25 patients with a positive snout reflex, had significantly lower counts of large pyramidal cells in layers III through V of the frontal cortex (area 32). These results indicate that different neurologic symptoms in Alzheimer's disease can be related to disproportionate neuronal degeneration in functionally different brain areas.
Aged↗
Clinical and neuropathological correlates of depression in Alzheimer's disease.
Depressive symptoms have been reported in patients with mild to moderate Alzheimer's disease (AD). Recent evidence suggests that a noradrenergic deficit originating from neuronal degeneration in brainstem nuclei may represent an organic correlate of these disturbances. We examined the neuropathological changes in the locus coeruleus (LC), substantia nigra (SN), basal nucleus of Meynert and cortex of 52 patients (12 male, 40 female, mean age 83.2 +/- 6.4 years) with pathologically verified AD. Fourteen patients (1 male, 13 female) showed signs of depression. The majority of these patients suffered from severe physical disability or sensory impairment and developed persistent delusions, but had less cognitive impairment. Neuronal counts in the LC were significantly lower than in the 38 patients without depression (36.9 +/- 14.0; 51.4 +/- 28.0 neuromelanin-pigmented cells per section per nucleus; F = 3.4, df = 1, 50, P = 0.04). Neuron counts were higher in the basal nucleus of Meynert in depressed AD patients and there were no differences of the neuron numbers in the SN. Depression (main effect; F = 4.5, P = 0.04) contributed significantly to the variance of neuronal counts in the LC, even when covarying for gender, age of onset, cognitive impairment and cortical Alzheimer pathology. The observed disproportionate loss of noradrenergic and cholinergic neurons in the LC and basal nucleus of Meynert may represent an important organic substrate of depression in AD.
Aged↗
Psychiatric phenomena in dementia of the Alzheimer type.
Psychiatric symptoms and behavioral disturbances are of importance in dementia of the Alzheimer type (DAT) but have been relatively neglected by researchers. The main psychiatric symptoms are disorders of thought content (delusions and paranoid ideation), disorders of perception (hallucinations and misidentifications) and disorders of affect (depressed and elevated mood). They occur commonly in DAT, and there is evidence that they may indicate subtypes of the disorder in view of their demographic, structural, and prognostic correlates. Personality changes are very common, and these may be the earliest manifestation of dementia. Behavioral disturbances tend to be associated with advanced dementia and are particularly disruptive to caregivers. Structural correlates suggest that some behaviors are a direct result of brain damage. Psychiatric and behavioral features in DAT are important, as they may serve as a model for symptomatology in functional psychiatric disorders.
Aged↗
HLA class II specificities in vasculitis with antibodies to neutrophil cytoplasmic antigens.
HLA class II genes were examined in patients with small vessel vasculitis associated with anti-neutrophil cytoplasmic antibodies (ANCA) using restriction fragment length polymorphism and allele specific oligonucleotide typing. Fifty-nine patients were studied, 34 with Wegener's granulomatosis and 25 with microscopic polyarteritis, and their results were compared with those from 1103 British Caucasoid controls. The frequency of HLA-DQw7 was significantly increased in patients with vasculitis (patients 53%; controls 27.8%, chi 2 17.8, Pc less than 0.0025, relative risk 2.9), and all the DQw7 bearing haplotypes commonly found in Caucasoid populations contributed to the increase. By contrast, the frequency of HLA-DR3 bearing haplotypes was decreased in the patients (patients 6.8%; controls 21.6%, chi 2 6.7, P less than 0.01). HLA specificities were similar in the groups of patients presenting with Wegener's granulomatosis and microscopic polyarteritis and with different types of ANCA assessed by indirect immunofluorescence. However, patients with the DQw7, DR4 haplotype were significantly more likely to have transiently positive tests for ANCA than patients with other DQw7 bearing haplotypes, whereas patients with DR2 bearing haplotypes were more likely to have persistently positive ANCA. These results show that HLA class II genes are associated with small vessel vasculitis and may influence the duration of the associated autoimmune response.
Antibodies, Antineutrophil Cytoplasmic↗
Association of age with regional cerebral oxygen utilization: a positron emission tomography study.
Positron emission tomography scans were performed on 14 normal subjects over the age of 50. Cerebral metabolic rate for oxygen (CMRO2) was assessed in a number of cortical and subcortical regions. There was a trend for a decrease in CMRO2 with age but this was significant only in the parietal lobe. There was a suggestion that the age/CMRO2 correlation became less strong with advancing age. CMRO2 in the occipital lobe, subcortical regions and cerebellum was not related to age. The relationship between CMRO2 and age is discussed.
Aged↗
Morphologic (CT) and functional (rCBF-SPECT) correlates in Alzheimer's disease.
Thirty-five patients with a clinical diagnosis of probable Alzheimer's disease underwent computed tomography (CT) and regional cerebral blood flow (rCBF) studies using single photon emission computed tomography (SPECT). Two sets of images in each subject were scored for the extent of structure and function changes. Thirty-four of 35 patients had various degrees of atrophy on CT, 33 of whom also had perfusion deficits of varying severity. One patient with normal CT had perfusion deficits, and another patient with a normal perfusion pattern had changes on CT. Regional perfusion deficits on SPECT were seen with and without associated changes on CT. Correlations were studied between CT and SPECT scores using Spearman's rank correlation coefficients. While regional scores on CT and SPECT did not significantly correlate, the total and left hemisphere scores on two sets of images showed fair correlations (r = 0.425 and r = 0.535, respectively, P less than 0.01). The correlations between cognitive performance in patients as assessed on Mini-Mental State Examination (MMSE) and CAM-COG and perfusion scores were highly significant while CT scores showed lower correlations. These findings suggest that the relationship between structural and functional changes in Alzheimer's disease is not straightforward and that the extent of changes in function as assessed by regional cerebral blood flow studies is a reliable measure of deficits in cognitive function.
Aged↗
Re: Eosinophilic prostatitis and prostatic specific antigen. S. Liu et al. Br. J. Urol., 69, 61-63, 1992.
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Asthma↗
Effect of dichloroacetate on mechanical performance and metabolism of compromised diaphragm muscle.
We investigated the effect of dichloroacetate (DCA) on tension generation and carbohydrate metabolism of the rat diaphragm in vitro. Isolated diaphragms were placed in individual organ chambers and were hooked to force-displacement transducers. Net lactate production and glucose and lactate oxidation were measured in vitro. Diaphragmatic fatigue was precipitated by in vivo endotoxemic shock, by in vitro hypoxia, or by in vitro repetitive tetanic stimulation. In diaphragms isolated from endotoxemic rats, DCA increased tension generation by 30 and 20% at stimulation frequencies of 20 and 100 Hz, respectively. Associated with changes in mechanical performance, DCA reduced net lactate production by 53% after 60 min of incubation and increased glucose oxidation 54% but had no effect on lactate oxidation. During in vitro hypoxia, DCA reduced net diaphragmatic lactate production by 30% and increased glucose oxidation by 45% but did not attenuate hypoxic fatigue. DCA had no effect on tension generation during repetitive tetanic stimulation. We conclude that DCA improves in vitro diaphragmatic fatigue due to endotoxicosis but not due to hypoxia or repetitive stimulation.
Animals↗
First-rank symptoms of Schneider in late paraphrenia. Cortical structural correlates.
The brains of 41 late paraphrenics, 16 of whom had first-rank symptoms, were examined by CT. Late paraphrenics with first-rank symptoms had significantly less cortical atrophy than those without them.
Aged↗
Delusional memory in schizophrenia.
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Delusions↗
[Organic correlates of depressive symptoms in Alzheimer's dementia. Results of a prospective study, review of the literature].
The diagnosis of Alzheimer's disease (AD) was verified at post-mortem examination in 46 patients (9 male: 37 female; mean age 83.6 +/- 6.5 years) from a prospective clinical study. Compared to 10 age-matched controls, the total AD group showed a significant neuronal loss in the locus coeruleus, dorsal raphe nucleus, substantia nigra and in the basal nucleus of Meynert. Twelve patients (1 male: 11 female) had experienced symptoms of depression. These patients had significantly lower neuronal counts in the locus coeruleus, but less severe cell loss in the basal nucleus of Meynert compared to the AD patients without depression.
Aged↗
Efficacy of CAPD as the primary treatment for end-stage renal failure in children.
In the 6 years before this paper, all children presenting with end-stage renal failure (ESRF) in Northern Ireland were electively commenced on continuous ambulatory peritoneal dialysis (CAPD). In that period, 22 patients were treated, 16 received renal transplants and 6 remained on CAPD. Active treatment was withdrawn in 1 child due to obliterative peritonitis. There were no deaths. One incident of peritonitis was documented per 11.6 patient treatment months. Recurring peritonitis lead to catheter replacement in 3 patients. Other problems encountered were catheter exit site infections, hernia formation and in one instance, hydrothorax. Peritonitis was more common in children under 2 years of age as was undernutrition, growth retardation and developmental delay. Home CAPD can be recommended as a viable first option treatment for childhood ESRF where suitable haemodialysis facilities are not easily accessible.
Adolescent↗
The effect of a fish oil enriched diet on oxygen toxicity and lipid peroxidation in mice.
Mice were fed a chow diet or diets enriched in fish oil, sunflower oil or beef tallow for 3 weeks. Fatty acid analysis was carried out in samples of plasma, brain and lungs from these animals and large changes were found in plasma and lungs with relatively small dietary-induced changes in brain tissue. Bleeding times were increased very significantly in the fish oil group, and slightly increased in the sunflower oil group. Endogenous lipid peroxidation (measured as thiobarbituric acid reactive substances) was unchanged in lung and brain, but lung tissue from fish oil fed mice produced more lipid peroxides in vitro during incubation at 37 degrees than those of other dietary groups. Mice fed the four different diets were exposed to hyperbaric oxygen at 618, 585 and 515 kPa and convulsive activity and lung damage was recorded. No dietary-induced alterations in susceptibility to oxygen toxicity were found.
Animals↗
Computed tomography in Alzheimer's disease: a longitudinal study.
Sixty-three patients satisfying NINCDS/ADRDA criteria for Alzheimer's disease (AD) received neuropsychological tests and computed tomography (CT) scans 12 months apart. Significant deterioration occurred in all the cognitive tests and in the CT measures used, that is, lateral ventricular size, third ventricular size, and cortical atrophy. There was a wide variation in the size of the changes taking place; 14 of 63 patients showed no significant change and 6 showed a marked increase in ventricular size. However, neither group differed from the others in any demographic, cognitive, or other CT variables which suggested, on the CT measures used, that no clearly identifiable subgroups of AD were present. Change in CT indices was not related to initial severity of disease. An increase in ventricular size was related to deterioration of cognitive function. These results require further replication. The methodological drawbacks of such studies are discussed.
Aged↗
Modelling length bias in a longitudinally-linked record system of HIV cases.
We compare numbers of hospital admissions for intravenous drug using (IVDU) HIV patients and other HIV patients in acute-care facilities in New York State. Data consist of routinely collected hospital-discharge reports from New York's Statewide Planning and Research Cooperative System, linked into longitudinal case histories. Because recognition of an IVDU depends on an opioid diagnosis on any record in the case history, the observed distribution of the number of admissions per case for recognized IVDU's is biased towards greater numbers of admissions. We develop and apply a model to overcome this biasing. Our findings reveal that the mean numbers of admissions for the two groups differ significantly, but less so than without recognition of the length biasing.
Bias↗