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Biomedical subjects

C P Hughes

Publications and source records attributed to C P Hughes.

At least 19 recordsLinked to original sources
PubMed1992

Community psychiatric nursing and depression in elderly people.

This paper invites community psychiatric nurses (CPNs) working with the elderly to examine their involvement with elderly people who are depressed. It does this by examining a selection of the more recent literature on the topic of depression in the elderly and discusses how this might inform and guide the CPN in his/her practice with this client group. Areas from within the literature which are examined in this paper are: the prevalence of depression in the elderly; problems of underdetection and undertreatment; classification; screening instruments; social factors in causation; prognosis following treatment; and psychological therapy. The literature is shown to have much to offer in aspects of CPN role such as: assessment and planning of care, including psychological therapy; liaison with, and education of, other professionals; screening; and primary prevention. The nursing literature of this CPN specialism, where it relates to depression, is also examined. Although developments in psychiatric services specifically for the elderly were mainly as a response to the illnesses causing dementia, this paper emphasizes that depression is the more common disorder in the elderly. It is suggested therefore that a CPN service should ensure that it is significantly orientated to the needs of this client group.

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PubMed1991

Community psychiatric nursing and the depressed elderly: a case for using cognitive therapy.

This paper examines whether the literature suggests that Beck's cognitive therapy is a treatment helpful to depressed elderly people, and highlights the issues and adaptations which are considered in its use with this client group. Evidence from outcome studies and case studies is presented which does suggest that it is helpful. A number of issues are raised which require certain special sensitivities on the part of the therapist. Evidence is discussed which suggests that certain adaptations to style and content of therapy may be needed for it to be maximally effective. It is argued that the use of cognitive therapy by community psychiatric nurses (CPNs) could contribute to making the service to depressed elderly people more comprehensive.

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PubMed1984

Psychometric differentiation of mild senile dementia of the Alzheimer type.

A brief (ten-minute), easily administered battery of four psychological tests was developed to classify successfully 98% of patients with mild dementia of the Alzheimer's type and healthy older persons matched for age, sex, and social position. Only two of 84 persons (one demented, one healthy) were misclassified. The four tests are the logical memory and mental control subtests of the Wechsler Memory Scale, Form A of the Trailmaking Test, and word fluency for letters S and P.

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PubMed1984

Predictive features in mild senile dementia of the Alzheimer type.

Forty-three subjects with mild senile dementia of the Alzheimer type, diagnosed and staged by clinical research criteria, were studied with clinical, psychometric, EEG, visual evoked potential, and CT measures. During the 12 months following entry into the study, 21 subjects progressed to moderate or severe dementia, 21 remained mild, and one was lost to follow-up. Many of the clinical and psychometric measures of impairment were predictive of the progression to moderate or severe dementia. Electrophysiologic and CT measures were not. In a discriminant function analysis, the scores on two measures (the digit symbol subtest of the Wechsler Adult Intelligence Scale and an Aphasia Battery) correctly predicted the stage of dementia 1 year later in 95% of the subjects.

Activities of Daily Living↗
PubMed1983

Aprosodia in Chinese patients with right cerebral hemisphere lesions.

Recent publications, all involving native speakers of English, have established that lesions in the right cerebral hemisphere produce a deficit in the comprehension and execution of tonal change in language related to the affective component of prosody. We tested 12 Chinese patients with right-hemisphere lesions and seven controls for comprehension, discrimination, repetition, and expression of prosody and gesture. In 11 of the 12 patients, aprosodia was identified. The subjects were also tested for their ability to detect semantic tonal difference in Chinese. Only five of the 12 showed a mild deficit in this task, suggesting that the left cerebral hemisphere is more dominant for comprehension of tone essential to word meaning.

Adult↗
PubMed1983

Visual evoked potentials in mild senile dementia of Alzheimer type.

Visual evoked potentials (VEPs) to chessboard shift and to flash stimulation were recorded from 40 subjects with senile dementia of Alzheimer type (SDAT) and 40 individually matched control subjects. All of the SDAT subjects had only a mild degree of dementia and were still living in the community. Analysis of variance showed significant differences between demented and control group means for 3 chessboard shift VEP measures, the demented group having longer latency of peaks P3 and N3, and larger amplitude of segment N2-P3. These three are the earliest reported changes in the VEP in Alzheimer disease, since the flash VEPs showed no measure in which the demented and control group means differed significantly.

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PubMed1983

Visual function in the ventral lateral geniculate nucleus of the cat.

The visual receptive fields of 293 single units in the ventral lateral geniculate nucleus of the cat were studied. In addition to the wide variety of types described by others, a group of units responding differentially to color was identified that included units responding particularly to blue and others with opponent color properties. Some units with spontaneous firing and without definite visual receptive fields were inhibited by stimulation of the optic chiasm (OX). A study of latency of firing to OX stimulation suggested that these cells were driven by retinal ganglion cells of the W type. One-third of all units studied were binocularly driven.

Afferent Pathways↗
PubMed1983

Brain parenchymal density measurements by CT in demented subjects and normal controls.

Parenchymal density measurements of 14 regions of gray and white matter from each cerebral hemisphere were made from CT scans of 25 subjects who had varying degrees of dementia as measured by a global Clinical Dementia Rating, and also from CT scans of 33 normal control subjects. There were few significant differences between the two groups in the mean density value for each of the regions examined, although several individual psychometric tests did correlate with density changes. Moreover, for six regions in the cerebral cortex, and for one region in the thalamus of each hemisphere, we found no significant correlation between the gray-white matter density difference and dementia. There was, however, a loss of the discriminability between the gray and white matter with an increase in the size of the ventricles. These findings may be attributed to the loss of white matter volume.

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PubMed1982

Mild senile dementia of Alzheimer type: research diagnostic criteria, recruitment, and description of a study population.

Clinical investigations of senile dementia of the Alzheimer type require establishment of explicit clinical diagnostic criteria before histological confirmation is possible. Criteria for selection of mildly impaired subjects with senile dementia of Alzheimer type, free of other major disease, are proposed. Problems of recruitment of this select population for a longitudinal study are discussed. A study population with matched healthy control subjects has been enrolled and described. Short term follow-up has provided preliminary support for the diagnostic criteria.

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PubMed1982

Volumetric measurements of the cerebrospinal fluid spaces in demented subjects and controls.

Forty-seven subjects 65 to 80 years of age, of whom 20 were demented and 27 were normal, were studied by computed tomography. Volumetric indices of ventricular (V%) and sulcal size (S%) were determined by pixel counts without knowledge of clinical status. V% was 5.30 (+/- 1.92) for the controls and 10.46 (+/- 4.78) for the demented subjects. S% was 6.14 (+/- 2.51) for the controls and 10.61 (+/- 3.32) for the demented subjects. In each case, differences between the two groups were significant (P less than 0.0001). When a subsample of 29 scans were analyzed using linear and volumetric measurements, the linear measurements showed less pronounced differences between the demented subjects and the controls. These findings explain the conflicting results of different investigators concerning variations in ventricular and sulcal size in dementia and normal aging.

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PubMed1982

A new clinical scale for the staging of dementia.

Accurate clinical staging of dementia in older subjects has not previously been achieved despite the use of such methods as psychometric testing, behavioural rating, and various combinations of simpler psychometric and behavioural evaluations. The Clinical Dementia Rating (CRD), a global rating device, was developed for a prospective study of mild senile dementia--Alzheimer type (SDAT). Reliability, validity, and correlational data are discussed. The CRD was found to distinguish unambiguously among older subjects with a wide range of cognitive function, from healthy to severely impaired.

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PubMed1981

Afferent projections to the ventral lateral geniculate nucleus in the cat.

Horseradish peroxidase (HRP) injections were made into the dorsal lateral geniculate nucleus (LGNd) and ventral lateral geniculate nucleus (LGNv) of the cat in order to define afferent projections to LGNv. These were found from the superior colliculus, contralateral LGNv, dorsal median raphe nucleus, locus coeruleus, ipsilateral pretectum, and various portions of visual cortex. While many cortical areas project to LGNv (17, 18, 19, 21 and lateral suprasylvian), the heaviest input arises from areas 17 and 20. The cell bodies of origin are in layer 5 in contrast to layer 6 which projects to LGNd.

Afferent Pathways↗
PubMed1978

Observations on the afferent and efferent connections of the avian isthmo-optic nucleus.

The efferent and afferent connections of the avian isthmo-optic nucleus (ION) were studied using light microscopic techniques. Injections of [3H]proline into the nucleus resulted in labeling of centrifugal endings in the retina at the junction of the inner plexiform layer and inner nuclear layer, but produced no other transported label to any thalamic or mesencephalic nucleus. The origin of the tectal afferents to the ION was demonstrated by means of injections of [3H]proline into the most superficial layers of the optic tectum and by stereotaxic injections of horseradish peroxidase into the ION. The tectal efferent cell bodies were located in lamin h of the optic tectum and at the junction of laminae h and i.

Animals↗
PubMed1978

Adult idiopathic communicating hydrocephalus with and without shunting.

The outcome in 37 adult patients with idiopathic communicating hydrocephalus treated by ventriculoatrial shunting is presented. Only 33% showed definite improvement, and no diagnostic procedures accurately predicted the outcome of surgery. These were compared with a "control" group of 12 patients who were not shunted; 50% of these were stable for up to 36 months. These findings, and the high frequency of serious complications (35%), suggest caution in recommending a shunt procedure.

Aged↗
PubMed1977

Cerebral blood flow, oxygen utilization, and blood volume in dementia.

Patients with dementia had significant decreases in cerebral blood flow and cerebral oxygen utilization and a mild, but not significant, increase in cerebral blood volume. These studies were not useful in distinguishing patients with cerebral atrophy from patients with normal pressure hydrocephalus, as similar changes in cerebral circulation and metabolism were seen in both groups. Changes in cerebral blood flow after acute decrease in the intracranial pressure also were not helpful differentiating patients with normal pressure hydrocephalus from patients with cerebral atrophy.

Blood Volume↗
PubMed1976

Functional role of efferents to the avian retina. I. Analysis of retinal ganglion cell receptive fields.

Receptive fields of retinal ganglion cells were analyzed during extracellular microelectrode recordings in the optic tract of the lightly anesthetized pigeon. Four major types of receptive field can be distinguished among the 359 fibers studied. Twenty-five percent of the receptive fields are relatively simple, responding at on and at off to stationary spots of light in the central region. All of the receptive fields have inhibitory surrounds of varying strength that do not produce a response when illuminated alone, but antagonize responses from the central region. Motion sensitive units comprise 15% of the recorded population; they are similar to the on-off center type except that responses to stationary stimuli are absent or very weak while responses to moving stimuli are virorous. Directionally selective units also have the basic features of on-off, inhibitory surround cells, but respond to moving stimuli well from the preferred direction and not at all from the null direction. Directional cells have a broad range of null directions; in about one-third of the units the range becomes broader when the stimulus involves both center and surround of the receptive field, thus enhancing directional selectivity. Directionally selective units are common, comprising 38% of the units studied. Cells unresponsive to stimuli moving from anterior in the visual field are much more common than other types, while cells unresponsive to stimuli from posterior in the field are rare. A few units (11%) respond only at on or at off to stationary stimuli in their receptive field centers; they also have antagonistic but unresponsive receptive field surrounds. The area of the visual field sampled is uniform in regard to the relative numbers of the four major receptive field types.

Animals↗