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Biomedical subjects

C Regan

Publications and source records attributed to C Regan.

At least 19 recordsLinked to original sources
PubMed2006

Relationship of vascular risk to the progression of Alzheimer disease.

OBJECTIVE: To test the hypothesis that patients with Alzheimer disease (AD) who have vascular risk factors have a worse prognosis over 18 months vs those without such risk factors. METHODS: A sample of 224 people with AD and their caregivers were recruited purposively to be representative of people with dementia in terms of cognition, sex, and living situations in a longitudinal study of AD. Standardized instruments measuring cognition, functional status, and neuropsychiatric symptoms were used to collect data. Physical examination and relevant blood tests were performed. RESULT: There was no difference in rate of deterioration between people with and without vascular risk factors, except in those who had a cerebrovascular accident (CVA) during the 18-month follow-up (p < 0.001). We considered possible confounders of outcome: sex, age, years of education, severity of dementia, depression, taking cholinesterase inhibitors (AChEIs), and whether those with vascular risk factors were more likely to die, but the results remained unchanged. Stopping AChEIs during the study was associated with cognitive and functional decline (p < 0.001). CONCLUSIONS: Vascular risk factors as measured clinically and biochemically do not significantly increase deterioration at 18 months in people with Alzheimer disease who have a low burden of cerebrovascular risk factors. However, cerebrovascular events are associated with more rapid decline. Vascular risk factors may contribute to the expression of Alzheimer disease initially but are not part of the underlying etiologic process.

Aged↗
PubMed2005

The Caregivers for Alzheimer's disease Problems Scale (CAPS): development of a new scale within the LASER-AD study.

BACKGROUND: we developed the Caregivers for Alzheimer's disease Problems Scale (CAPS) comprising common risk factors for anxiety and depression for family carers of people with dementia. OBJECTIVE: to calculate the sensitivity and specificity of the CAPS in order to measure its usefulness in identifying dementia caregivers at risk of anxiety and depression and therefore whether it identifies clinically relevant areas for intervention or highlights the need for support if the problem could not be changed. METHOD: 153 family caregivers were interviewed as part of a larger epidemiologically representative study of people with Alzheimer's disease and their caregivers. Caregiver anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). RESULTS: the CAPS had high sensitivity and specificity in detecting caregivers with screen positive anxiety and depression. Five areas were indicated: neuropsychiatric symptoms and depression in the care-recipient, co-residence and relationships with the care-recipient, and physical health of the caregiver. CONCLUSIONS: awareness of these problems can help clinicians identify those carers most likely to be anxious or depressed and indicate appropriate intervention and support. We recommend that this instrument be used as part of routine assessments of people with dementia and their families.

Adult↗
PubMed2005

Administrative registers in psychiatric research: a systematic review of validity studies.

OBJECTIVE: To conduct a systematic review of studies investigating the validity of administrative registers for use in psychiatric research. METHOD: Studies were identified using MEDLINE (1966-2004) and EMBASE (1980-2004) databases using keywords 'validity' or 'reliability' combined with 'register' or 'database$'. Studies reviewed by two raters blind to each other and quality assessed using a data extraction form devised by the authors. A narrative description of the findings is presented. RESULTS: Fourteen studies were identified, seven of which concerned Scandinavian registers. Ten studies were solely concerned with diagnostic validity and the most common single diagnosis studied was schizophrenia (five studies). Methods used and study quality varied widely. CONCLUSION: Given the importance of the area, relatively little high-quality work exists into systematically measuring the diagnostic data validity of registers for research purposes.

Biomedical Research↗
PubMed2004

The role of investigations for term stillbirths.

The aim of the study was to document the role of laboratory investigations for unexpected stillbirths at term. It was a retrospective casenote review of 75 unexpected stillbirths at term from 1995 to 1999, at the National Maternity Hospital, Dublin, Republic of Ireland. Investigations performed included blood tests, chromosomal analysis, autopsy and placental histology. Perinatal autopsy was the most informative investigation with positive findings in 49% of cases. There were positive placental findings in 37% of cases. Six of the 26 cases showed abnormal karyotyping. Of the blood tests performed, the Kleihauer-Betke test was most informative, revealing a feto-maternal haemorrhage in 8% of cases and anticardiolipin antibodies were positive in 4% of cases. FBC, TORCH and glycosylated Hb were negative in all 75 patients. Despite thorough investigations 32 of cases (43%) remained unexplained.

Adolescent↗
PubMed2000

Prospective evaluation of the risk conferred by factor V Leiden and thermolabile methylenetetrahydrofolate reductase polymorphisms in pregnancy.

Factor V (FV) Leiden and thermolabile methylenetetrahydrofolate reductase (MTHFR) are 2 common polymorphisms that have been implicated in vascular thrombosis. We determined whether these mutations predicted an adverse outcome in pregnancy. Second, we looked for an interaction between these 2 mutations in patients with recurrent fetal loss or thrombosis in pregnancy. Primigravid subjects at their booking visit to the National Maternity Hospital (Holles Street, Dublin, Ireland) were screened for the polymorphisms. Thermolabile MTHFR and FV Leiden genotypes were detected by either restriction fragment length polymorphism or heteroduplex capillary chromatography. The carrier frequency of FV Leiden in the screened primigravid population was 2.7% (allele frequency 1.36%), all being heterozygous for the mutation. This value was lower than expected from previous studies in European populations. Forty-nine percent of the screened population (289 of 584) were heterozygous for thermolabile MTHFR, and 10.6% were homozygous (62 of 584). The frequency of the 2 polymorphisms was no higher in those who subsequently developed preeclampsia (n=12) or intrauterine growth retardation (n=9), and none of the screened population developed thrombosis. However, the frequency of FV Leiden was higher in patients who subsequently miscarried after the first trimester of pregnancy (allele frequency of 5.5%, P=0.0356). Among those positive for FV Leiden, 3 of 27 miscarried, compared with 24 of 572 of FV Leiden-negative patients (11% versus 4.2%). No interaction was found between the 2 mutations in the control or patient populations. In patients with a prior history of venous thrombosis, the carrier rate of FV Leiden was increased (4 of 33, allele frequency of 7.6%, P=0. 0115). In contrast, the carrier frequency for thermolabile MTHFR was no higher, and there was no interaction between the 2 mutations. Neither mutation occurred at a significantly higher frequency in patients with a prior history of recurrent fetal loss. In conclusion, FV Leiden is a risk factor for thrombosis in pregnancy and possibly for second-trimester miscarriage independent of thermolabile MTHFR. However, prospective analysis suggests that the risk conferred by FV Leiden is low in a primigravid population. The thermolabile MTHFR genotype was not implicated in any adverse outcome.

Abortion, Habitual↗
PubMed1999

Syntheses of benzoquinolizidine and benzoindolizidine derivatives as anti-amnesic agents.

Tacrine, one of the drugs available for Alzheimer's disease based on the cholinergic approach, suffers from considerable toxicity. Many analogues of tacrine have been prepared which retain the pharmacologically rich aminopyridine or aminoquinoline motifs. The current research was undertaken to produce an acetylcholinesterase inhibitor by employing 11-aminobenzoquinolizidines (4) and 10-aminobenzoindolizidines (5) as templates. Thus, we aimed to achieve three goals relative to tacrine: eliminate the pyridine and quinoline moieties and render the molecule less flat. Overall, the compounds we prepared were poorer inhibitors of acetylcholinesterase compared to tacrine. The single exception was compound 6f which exhibited an effect comparable to that of tacrine, but only at a dose of the order of 10(-3) M. However, despite the poor acetylcholinesterase inhibition by 6b, this compound proved to be an effective anti-amnesic agent at 45 mg/kg dose.

Animals↗
PubMed1999

Syntheses of 1,2-diamino and 1,2-aminoalcohol derivatives in the piperidine and pyrrolidine series as anti-amnesic agents.

Tacrine, one of the drugs available for Alzheimer's disease based on the cholinergic approach, suffers from considerable toxicity. Many analogues of tacrine has been prepared which retain the pharmacologically rich aminopyridine or aminoquinoline motifs. The current research is a continuation of our efforts in the area of 11-aminobenzoquinolizidines (4) and 10-aminobenzoindolizidines (5) (cf. ref9). A serendipitous discovery led us to the biologically active open chain analogue 9, and we proceeded to elaborate on this molecule. Overall, the compounds we prepared were poor inhibitors of acetylcholinesterase as compared to tacrine. The single exception was compound 20 which exhibited an effect comparable to that of tacrine, but only at a dose in the order of 10(-3) M. However, despite the poor acetylcholinesterase inhibition by 9, this compound was found to be an effective antiamnesic agent.

Alcohols↗
PubMed1996

The FcgammaRII receptor triggers pp125FAK phosphorylation in platelets.

Platelets express a single low affinity receptor for immunoglobulin, FcgammaRII, that triggers multiple cellular responses upon interaction with multivalent immune complexes. In this study we show that immobilized IgG is also a potent stimulant of platelet activation triggering adhesion, aggregation, massive dense granule secretion, and thromboxane production. Platelet adhesion to IgG was blocked by the FcgammaRII receptor-specific monoclonal antibody, IV. 3. Pretreatment of the platelets with cytochalasin D to inhibit actin polymerization similarly prevented cell binding to IgG having no effect on platelet binding to fibrinogen. Platelet adhesion to IgG also led to the induction of tyrosine phosphorylation of multiple proteins including pp125(FAK) and p72(SYK). These proteins were also tyrosine-phosphorylated in alphaIIbbeta3-deficient IgG-adherent platelets from patients with Glanzmann's thrombasthenia. These data demonstrate that FcgammaRII mediates pp125(FAK) phosphorylation and platelet adhesion to IgG independent of the integrin alphaIIbbeta3. Treatment of the platelets with bisindolylmaleimide to inhibit protein kinase C prevented phosphorylation of pp125(FAK) as well as several other proteins, but not p72(SYK) phosphorylation. This study establishes that the FcgammaRII receptor mediates pp125(FAK) phosphorylation via protein kinase C.

Antibodies, Monoclonal↗
PubMed1994

The weight and fitness status of United States children.

Although the prevalence of overweight and obesity among US children is a concern for many health care professionals, incidence rates over time seem to be variable, depending on the assessment measurements used. It is difficult to determine the associated health implications of pediatric obesity or overweight, especially the type that might result in adult obesity or overweight. This review examines the various factors that contribute to the weight and fitness status of children, including anthropometric factors, nutrient intake, the level of physical activity, and nutrition knowledge. Nutrient intake data of the past decade show that the energy and fat intakes of children in the United States have been fairly constant. However, data also indicate that their physical activity has declined. The data strongly suggest that the apparent prevalence of pediatric overweight may not be so much a function of nutrient intake as of a decrease in physical activity leading to an imbalance of energy input and output.

Adolescent↗
PubMed1993

Representations of attachment in mothers and their one-year-old infants.

Attachment classifications in mothers and their 1-year-old infants were independently and concurrently assessed using the Adult Attachment Interview and the Strange Situation Procedure. Overall concordance was significant (k = 0.62), with strong links apparent between mothers classified dismissing and infants classified avoidant and between mothers classified autonomous and infants classified secure. Mothers' classified preoccupied were not more likely to have infants classified resistant. Mothers' perceptions and interpretations of the emotional distress of an infant observed in a 4-minute videotape were related to both infant and mother attachment classifications. These results are compatible with the suggestion that attachment classification reflect differences in internal working models of relationships. Other measures of maternal psychosocial adjustment were not related to infant attachment classifications.

Adult↗
PubMed1987

Multinational operations of US for-profit hospital chains: trends and implications.

The expansion of United States for-profit hospital chains into the international arena is a new and important development. Experiences with contract management of middle eastern hospitals in the early 1970s gave the American firms impetus to pursue ownership of health facilities in other parts of the world. US companies now operate over 95 foreign hospitals. The reasons for this involvement include the political receptivity of the government of the host nation; the potential for rapid growth and profits; the lack of indigenous competition; and the ability to occupy a distinct niche within the extant health services organization. The political and ideological implications of the growth of private medicine, particularly in the United Kingdom, in terms of its effects on the National Health Service are discussed. Questions for future research are posed.

Global Health↗