PubMed HealthSearch

Biomedical subjects

D Ames

Publications and source records attributed to D Ames.

14 recordsLinked to original sources

A memory clinic at a geriatric hospital: rationale, routine and results from the first 100 patients.

OBJECTIVE: To describe the operation of a memory clinic with reference to the referral pattern, patient characteristics and psychiatric diagnoses, frequency of reversible dementias and utility of brief cognitive screening tools in the detection of dementia. DESIGN: All patients underwent cognitive screening tests (Mini Mental Status Examination, Abbreviated Mental Test Score, Organic Brain Syndrome Scale of the Brief Assessment Scale) and two activities of daily living instruments. Psychiatric diagnoses were made according to criteria of the Diagnostic and statistical manual, third edition revised, of the American Psychiatric Association (DSM-III-R). SETTING: A large geriatric hospital. SUBJECTS: First 100 patients referred. RESULTS: The mean age of the patients was 75.5 years and 75 were women. Seventy-four met DSM-III-R criteria for dementia and a further 13 had other organic brain syndromes. No case of reversible dementia which recovered was encountered. The cognitive screening tools had a high correlation (r = 0.85-0.89) with one another but a much lower correlation with the activities of daily living instruments (r = 0.27-0.37). CONCLUSION: Reversible dementias are unlikely to be detected in a memory clinic at a geriatric hospital, but the assessment process may have other benefits which will need to be assessed in prospective research. The clinic population represents a unique resource for further research on dementia.

Activities of Daily Living

Hypertrophic cardiomyopathy in systemic lupus erythematosus and "lupus-like" disease. Chance association? A report of 2 cases.

Two patients, both women, one with "lupus-like" disease, age 51 years, the other a 45-year-old with systemic lupus erythematosus (SLE), developed symptoms and echocardiographic signs of hypertrophic cardiomyopathy. One patient had a family history of sudden maternal death. Neither patient had a history of sustained hypertension and there were no significant valvular lesions detectable to account for the septal and ventricular hypertrophy. The association of SLE or any related condition with hypertrophic cardiomyopathy has not been recorded. In one patient the question of a hereditary cardiomyopathy remains a possibility. The diagnosis of the condition was based on clinical and echocardiographic grounds alone. No endomyocardial biopsies were performed.

Cardiomyopathy, Hypertrophic

Organic mental disorders associated with bupropion in three patients.

Bupropion hydrochloride is a phenylaminoketone antidepressant whose clinical pharmacology is poorly understood. Part of bupropion's action may be attributed to inhibition of dopamine reuptake that may induce organic mental disorders in certain susceptible patients. We report three cases of organic mental disorders in patients receiving bupropion hydrochloride for treatment of the depressed phase of their bipolar-type mood instability. The organic mental disorders that occurred in these patients were characterized largely by visual disturbances--visual hallucinations and visual illusions--although one patient also experienced auditory hallucinations. The patients' use of concomitant medications and potential drug interactions are carefully evaluated and the literature on bupropion's ability to induce organic mental disorders is reviewed. We suggest a number of possible mediating mechanisms for these syndromes including dose-related dopaminergic augmentation, accumulation of toxic metabolites, predisposition to psychosis, and drug interactions.

Adult

The amyloid precursor protein of Alzheimer's disease is released by human platelets.

Western blots of normal human platelets, employing a monoclonal antibody raised against the full-length amyloid precursor protein of Alzheimer's disease (APP695), revealed major bands of 100-110 and 120-130 kDa in both cytosolic, membrane, and released fractions. These species were similar in size to forms seen in brain preparations and in plasma. There was no difference in Western blots of platelet preparations from Alzheimer patients compared with controls. Purified platelet amyloid precursor proteins were sequenced and shown to be amino terminally homogeneous. Immunohistochemistry localized the antigen to the platelet and megakaryocyte and demonstrated weak immunostaining of some lymphocytes. Immunoprecipitation of material released from platelets demonstrated that sedimentable full-length APP with the carboxyl-terminal epitope, and soluble APP lacking the carboxyl-terminal epitope, may exist in the circulation. Western blots and carboxyl-terminal and amino-terminal APP radioimmunoassay of material released by platelets in response to stimulation revealed that platelets release APP during degranulation. The function of platelet APP is yet to be determined, but the present studies suggest a role in regulation of the coagulation cascade or in platelet aggregation.

Alzheimer Disease

Depression among elderly residents of local-authority residential homes. Its nature and the efficacy of intervention.

Of 390 residents in 12 local-authority homes for the elderly, 93 had evidence of depression on screening and underwent standard clinical assessment. Half had an affective disorder, and a further third had depressive symptoms in the setting of an organic mental disorder. The 93 residents had a high rate of physical illness and disability, undertook little social activity, and were visited infrequently. A range of interventions for depressed residents, the majority social in type, mostly proved difficult to implement. There was no evidence of efficacy of psychiatric intervention at three months; at one-year follow-up a quarter of study participants had died, and 28% of those who were reassessed for depression showed evidence of recovery.

Activities of Daily Living

Depression in the elderly.

Depression in the elderly is an eminently treatable disease. It may masquerade as a pseudo dementia--a reversible condition with proper treatment. The need for an eclectic approach to management is emphasised and the special needs of the elderly outlined.

Aged

A second retreat?

Explore the source record for details and available documents.

Community Mental Health Centers

Effects of dietary citrinin and aflatoxin on leg problems of broilers growtn on wire floors.

Dietary levels of citrinin of 62.5, 125 and 500 mug./g. diet or aflatoxin at a dietary level of 2.5 mug./g. of diet fed from 1-21 days of age did not inccrease the incidence of leg problems compared to control groups receiving no dietary nycotoxins. These data indicate that dietary contamination with these toxins does not account for the incidence of occasionally observed leg probelms in younger broiler chicks.

Aflatoxins