Caring for carers--a national problem.
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Biomedical subjects
Publications and source records attributed to B Draper.
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The myoD family of DNA binding proteins has been implicated in the control of myogenesis in a variety of organisms. Searches for homologs in the nematode Caenorhabditis elegans yielded only one gene, designated hlh-1, expressed in body-wall muscle cells and their precursors. To assess the role of hlh-1 in C. elegans myogenesis, genetic deficiencies spanning the hlh-1 locus were isolated after gamma irradiation. Embryos homozygous for these deficiencies exhibited extensive body-wall muscle differentiation, including expression of several characteristic myofilament proteins and weak contracile behavior. Thus, zygotic hlh-1 expression was not required for body-wall muscle precursors to adopt muscle cell fates.
Potentially reversible dementia is reviewed with reference to diagnosis, causes and outcome. Many disorders which cause cognitive impairment, such as drug toxicity and depression, fail to meet diagnostic criteria for dementia. These tend to have the best prognosis. Studies of the neuropsychiatric syndromes associated with disorders causing potentially reversible dementias suggest that dementia is an infrequent outcome and when it does occur, few cases recover. Factors predictive of improvement are short duration of symptoms and mild degree of cognitive impairment, usually subcortical in type. It is suggested that potentially reversible cognitive impairment would be a more accurate term as many cases are due to delirium and depression. While cases of well established dementia do not require extensive investigation, all cases should have a thorough clinical assessment as in many instances dual pathology exists and all require psychosocial management.
The future development of new psychogeriatric services in Australia may well depend upon the demonstration of their potential effectiveness and efficiency. Descriptive accounts of effective services provide ample guidelines, although formal evaluation is lacking. Examining the major psychiatric disorders of the elderly shows that most are functional. Effective acute psychiatric treatment is available for these. In dementia cases, effective therapies exist for the reduction of secondary behavioural disabilities in the sufferer and the stress on carers. Adequately resourced comprehensive psychogeriatric services would be best equipped to deliver such treatments.
Folie à deux has been infrequently reported in dementia patients. A case is described in which both partners with folie à deux suffered from an Alzheimer type dementia. The development and management of folie à deux in dementia is discussed.
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