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Biomedical subjects

Aylan Gimzal

Publications and source records attributed to Aylan Gimzal.

2 recordsLinked to original sources

[Mild cognitive impairment].

It is essential to determine whether memory impairment is accompanied by impairment in other cognitive areas in patients presenting with the complaint of forgetfulness. Furthermore, it should be established whether this impairment is associated with normal aging or dementia. Several terms have been suggested to identify cognitive disorders without dementia. Benign senescent forgetfulness, age-associated memory impairment and aging-associated cognitive decline are considered to fall within the limits of normal aging. A recently proposed term, mild cognitive impairment, as opposed to the terms mentioned above, identifies a transitional state between normal aging and dementia. With the use of criteria proposed for mild cognitive impairment, this disorder converts to Alzheimer's disease at a rate of 10-15 % yearly. However, in longitudinal studies different neuropsychological tests and assessment scales were used for the diagnosis of mild cognitive impairment, resulting in different conversion rates to Alzheimer's disease. Recently, it has been proposed to classify mild cognitive impairment according to memory and non-memory involvement as amnestic, multiple domain and non-memory single domain clinical subtypes. Furthermore, vascular, metabolic, traumatic and various etiologies other than degenerative etiology are mentioned. Besides the medications known to be effective for cognitive dysfunctions, memory enhancement training is suggested for treatment. A consensus on the diagnostic criteria for mild cognitive impairment, determining the subgroups and further studies on treatment are necessary.

Cognition Disorders↗

[Acute rheumatic fever, Sydenham's chorea and psychopathology].

Acute rheumatic fever (ARF) is an autoimmune disorder that is triggered by group A beta-hemolytic streptococcal infections. ARF consists of several combinations of carditis, polyarthritis and Sydenham's chorea, and rarely seen erythema marginatum and subcutaneous nodules. Sydenham's chorea is seen in about 20% of patients with ARF. As a late symptom of ARF, Sydenham's chorea usually occurs 3 months or longer after the streptococcal infection. Sydenham's chorea is a neuropsychiatric disorder that may present with emotional lability, anxiety, obsessive compulsive symptoms, attention deficit and hyperactivity symptoms or tics. Obsessive-compulsive symptoms occur in 70% of patients with Sydenham's chorea. The role of the autoimmune mechanisms and the dysfunction of the basal ganglia have been demonstrated in Sydenham's chorea. Antibodies against group A beta-hemolytic streptococcus cross-react with basal ganglia. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) shares the same mechanism with Sydenham's chorea, but PANDAS has not been shown to require penicillin prophylaxis. Thus it is important to distinguish between them. Sydenham's chorea is associated with adulthood OCD, Tourette syndrome and schizophrenia. These features make Sydenham's chorea an explanatory model for obsessive-compulsive disorder (OCD) and related disorders. This poststreptococcal disorder provides a treatment opportunity with new therapies like antibiotic therapy, plasma exchange and intravenous immunoglobulin therapy for psychiatric disorders. In this paper we summarize the phenomenological and treatment studies of OCD, attention deficit and hyperactivity disorder (ADHD), and tic disorders in subjects with ARF, with or without Sydenham's chorea.

English Abstract↗