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Biomedical subjects

G Rands

Publications and source records attributed to G Rands.

14 recordsLinked to original sources
PubMed2003

Does aspirin affect outcome in vascular dementia? A retrospective case-notes analysis.

BACKGROUND: Ischaemic vascular dementia shares risk factors with stroke. There is evidence that control of these risk factors may prevent or alter the course of vascular dementia. OBJECTIVE: To assess the effect of regular low-dose aspirin on outcomes for patients with vascular dementia. DESIGN: Retrospective analysis of hospital case-notes with further outcome information from telephone calls to general practitioners, social services and institutions. Comparison of outcomes for aspirin-treated and untreated patients. SETTING: One North London NHS Trust. PATIENTS: Seventy-eight patients with clinician's diagnosis of ischaemic vascular dementia, discharged from acute inpatient units between 1 January 1995 and 31 December 1997; 38 on aspirin. MAIN OUTCOME MEASURES: Survival times from dementia onset to institutionalization and death. RESULTS: Median survival time to institutionalization was 28 months and to death was 52 months. There was no overall difference between aspirin and non-aspirin groups for these outcomes. When data were stratified for social status, i.e. living alone or with carer when last at home, differences emerged for those living with carer. Aspirin was associated with a trend towards increased time to institutionalization (39 vs 22 months, p < 0.09) and a significant advantage in time to death (71 vs 27 months, p = 0.02). These effects were non-significant after statistical adjustment for confounding variables. CONCLUSIONS: The results support but do not prove a role for regular, low-dose aspirin in improving both life expectancy and survival at home for patients with vascular dementia. Compliance may be better in those living with a carer. Larger, prospective studies should be performed to confirm these findings. Cognitive and behavioural outcomes should also be studied.

Age of Onset↗
PubMed2003

Variation in the DCP1 gene, encoding the angiotensin converting enzyme ACE, is not associated with increased susceptibility to Alzheimer's disease.

OBJECTIVES: To attempt to replicate previous reports that polymorphic variation in the DCP1 gene causes increased susceptibility to the development of Alzheimer's disease, either on its own or in interaction with the effects of the gene for apolipoprotein E (APOE). METHOD: Subjects older than 65 years of age consisting of 81 dementia patients diagnosed as having possible or probable Alzheimer's disease and 68 controls were obtained from Camden, Islington and Harlow psychiatric services. Subjects were genotyped for APOE alleles e2, e3 and e4, and the common insertion/deletion polymorphisms for DCP1* I/D were genotyped. RESULTS: There was no statistically significant difference in the frequency of the DCP1* insertion/deletion alleles between the cases and controls (X2 =0.04, 1 degree of freedom, not significant). When subjects were subdivided according to whether they possessed at least one copy of the APOE e4 allele, there were still no differences in DCP1 allele frequencies between cases and controls. CONCLUSIONS: Further research is needed to elucidate any role that the DCP1 polymorphism may play in relation to Alzheimer's disease. Previous studies may be false positive, or inconsistency in replication may be due to heterogeneity.

Aged↗
PubMed2000

Aspirin for vascular dementia.

BACKGROUND: For patients with a diagnosis of vascular dementia there is evidence that aspirin is widely prescribed - in one study, completed by geriatricians and psychiatrists in the UK, 80% of patients with cognitive impairment (with vascular risk factors) were prescribed aspirin. However, a number of queries remain unanswered: Is there convincing evidence that aspirin benefits patients with vascular dementia? Does aspirin affect cognition or improve prognosis? In addition, does the risk of cerebral or gastric haemorrhage outweigh any benefit? The aim of this review is to assess the evidence of effectiveness of aspirin in those with a diagnosis of vascular dementia. OBJECTIVES: To assess the evidence of effectiveness of the use of aspirin for vascular dementia. SEARCH STRATEGY: Computerised databases were searched independently by two reviewers. In addition, relevant websites were searched and some journals were handsearched. Specialists in the field were approached for unpublished material and also any publications found were searched for additional references. SELECTION CRITERIA: All randomised controlled trials investigating the effect of aspirin for vascular dementia are included. Inclusion/exclusion of studies comprised systematic assessment of the quality of study design and the risk of bias. DATA COLLECTION AND ANALYSIS: Data were extracted independently by both reviewers, using a previously tested data extraction form and, where required, authors were contacted for data not provided in the papers. The aim was to evaluate data recorded via tools assessing cognitive and behavioural changes along with mortality, morbidity and institutionalisation data. MAIN RESULTS: One randomised controlled trial ( approximately approximately Meyer 1989 approximately approximately ) was included, and yielded data for analysis on a total of 70 patients. The only relevant outcome assessed in this trial was cognition. Change in cognitive outcome was towards being in favour of treatment. REVIEWER'S CONCLUSIONS: There is very limited evidence that aspirin is effective in treating patients with a diagnosis of vascular dementia. Further research is needed to assess the effect of aspirin on cognition, and also on additional outcomes such as behaviour, and quality of life. At present it is not possible to provide evidence for other queries regarding the use of aspirin for dementia (these are described in the Background section of this review).

Aspirin↗
PubMed1998

Psychiatric disorders after transurethral resection of the prostate.

Three men in their 70s had long-term changes in mood and personality dating from immediately after transurethral prostatectomy. Focal abnormalities in the brain were not detected. The possibility of psychiatric as well as cardiovascular sequelae from this operation deserves investigation.

Aged↗
PubMed1997

Working people who also care for the elderly.

The workforce of a district health authority in south east England was surveyed using two successive postal questionnaires, to determine how many of them had outside work caring commitments to elderly persons. Details of the services and supports received by care receivers and caregivers were further analysed and ways in which worker-carers could be assisted by employers and work colleagues were explored. Fourteen per cent of this workforce had outside work commitments to caring for elderly people (17% of part-time workers and 12% of full-time workers). Worker-carers were usually female, older than non-carers, working part-time and earning low incomes. They tended to be caring for elderly female relatives, living close by, and approximately half were unaided by statutory or voluntary services. Worker-carers' support was mainly from family and friends. At work a supportive and accepting attitude from colleagues and line-managers was valued, as were part-time jobs and flexihours. Seventy-eight per cent of worker-carers wanted to continue with their dual roles. More attention, particularly within the work environment, needs to be paid to ways of supporting working people who also care for the elderly.

Aged↗
PubMed1989

Aspects of health care in China.

I work in nurse education mainly running courses concerned with family planning and health screening, so my particular interest was to look at those services, and the training provided to staff. I wished to look both at the urban facilities but particularly the 'barefoot doctor' training and the services they provided in the rural areas. Within the factories I wanted to talk to staff to see if their service equated with our occupational health service.

China↗
PubMed1981

Behavioural correlates of an experimental hippocampal epileptiform syndrome in rats.

Experiments are reported describing assessment of abnormal behaviour of rats in which a chronic epileptiform syndrome has been induced by the injection of tetanus toxin bilaterally into their hippocampi. The abnormal behaviour included hyper-reactivity to a novel environment, intermittent aggression on handling, and abnormally passive response to a strange rat introduced into their home cage. In animals with unilateral injection of toxin, electrical records from the hippocampi have been obtained. They illustrated bilaterally simultaneous discharges and also some independence between the two hippocampi. The discharges were accompanied by overt signs of complex partial seizures during the first few weeks of the syndrome but later occurred without motor signs. In this later stage the rats were somewhat resistant to the convulsant effects of pentylenetetrazol.

Aggression↗