PubMed Health⌕ Search

Biomedical subjects

R Mizrahi

Publications and source records attributed to R Mizrahi.

At least 19 recordsLinked to original sources
PubMed2006

A diagnostic formulation for anosognosia in Alzheimer's disease.

OBJECTIVE: To determine the earliest symptoms of anosognosia in people with Alzheimer's disease and to validate a criteria-guided strategy to diagnose anosognosia in dementia. METHODS: A consecutive series of 750 patients with very mild or probable Alzheimer's disease attending a memory clinic, as well as their respective care givers, was assessed using a comprehensive psychiatric evaluation. RESULTS: The factors of anosognosia for (1) basic activities of daily living (bADL), (2) instrumental activities of daily living (iADL), (3) depression and (4) disinhibition were produced by a principal component analysis on the differential scores (ie, caregiver score minus patient score) on the anosognosia questionnaire for dementia. A discrepancy of two or more points in the anosognosia-iADL factor was found to have a high sensitivity and specificity to identify clinically diagnosed anosognosia in people with Alzheimer's disease. By logistic regression analysis, the severity of dementia and apathy were both shown to be noticeably associated with anosognosia in people with Alzheimer's disease. CONCLUSION: Anosognosia in those with Alzheimer's disease is manifested as poor awareness of deficits in iADL and bADL, depressive changes and behavioural disinhibition. The frequency of anosognosia is found to increase considerably with the severity of dementia. The validity of a specific set of criteria to diagnose anosognosia in people with Alzheimer's disease was shown, which may contribute to the early identification of this condition.

Activities of Daily Living↗
PubMed2006

A prospective longitudinal study of apathy in Alzheimer's disease.

BACKGROUND: Apathy and depression are the most frequent behavioural and psychiatric disorders in Alzheimer's disease, and may both have a negative impact on the progression of the illness. OBJECTIVES: To examine the clinical correlates of apathy in Alzheimer's disease (AD), and to determine whether apathy is a significant predictor of more rapid cognitive, functional and emotional decline. METHODS: Using a structured psychiatric evaluation, we examined a consecutive series of 354 subjects meeting clinical criteria for AD. Apathy was assessed by the Apathy Scale, and diagnosed using standardised criteria. Additional measurements included scales for depression, functional impairment, and global cognitive functions. A follow up evaluation was carried out in 247 patients (70% of the total sample) between 1 and 4 years after the baseline evaluation. RESULTS: Apathy was significantly associated with older age (p = 0.009), and a higher frequency of minor and major depression (p < 0.0001). Apathy at baseline was a significant predictor of depression at follow up (p = 0.01), and was associated with a faster cognitive (p = 0.0007) and functional decline (p = 0.006). CONCLUSIONS: Apathy in AD is a behavioural marker of a more aggressive dementia, characterised by a faster progression of cognitive, functional, and emotional impairment.

Aged↗
PubMed2005

On the overlap between apathy and depression in dementia.

BACKGROUND: Whereas apathy is increasingly recognised as a frequent abnormal behaviour in dementia, its overlap with depression remains poorly understood. AIMS: To assess the psychometric characteristics of a structured interview for apathy, and to examine the overlap between apathy and depression in dementia. METHODS: A total of 150 patients with Alzheimer's disease (AD) underwent a comprehensive psychiatric and cognitive assessment. RESULTS: Twelve per cent of the sample met criteria for both apathy and depression, 7% met criteria for apathy only, and 31% met criteria for depression only. Apathy (but not depression) was significantly associated with more severe cognitive deficits. Apathy and anxiety scores accounted for 65% of the variance of depression scores in dementia, and the diagnosis of apathy had a minor impact on the rating of severity of depression. CONCLUSIONS: The Structured Interview for Apathy demonstrated adequate psychometric characteristics. Using a novel structured interview for apathy in AD we demonstrated that whereas the construct of depression primarily consists of symptom clusters of apathy and anxiety, apathy is a behavioural dimension independent of depression.

Aged↗
PubMed2004

White matter hyperintensities are significantly associated with cortical atrophy in Alzheimer's disease.

BACKGROUND AND OBJECTIVE: Methodological variability in the assessment of white matter hyperintensities (WMH) in dementia may explain inconsistent reports of its prevalence and impact on cognition. We used a method of brain MRI segmentation for quantifying both tissue and WMH volumes in Alzheimer's disease (AD) and examined the association between WMH and structural and cognitive variables. METHODS: A consecutive series of 81 patients meeting NINCDS-ADRDA criteria for probable AD was studied. Nineteen healthy volunteers of comparable age served as the control group. Patients had a complete neurological and neuropsychological evaluation, and a three dimensional MRI was obtained. Images were segmented into grey matter, white matter, and cerebrospinal fluid. WMH were edited on segmented images, and lobar assignments were based on Talairach coordinates. RESULTS: Mild and moderate to severe AD patients had significantly more WMH than controls (p<0.05). WMH preferentially involved the frontal lobes (70%), were inversely correlated with grey matter cortical volume (R(2) = 0.23, p<0.001), and were significantly associated with vascular risk factors and with a worse performance on memory tasks. CONCLUSION: Objective measurements of tissue volumes in AD demonstrated that WMH are significantly related to cortical atrophy and neuropsychological impairment.

Aged↗
PubMed1983

Interrelationships between heat acclimation and salivary cooling mechanism in conscious rats.

1. Adaptation of salivary cooling mechanism during acclimation to heat (34 degrees C) and its role in thermoregulation of the rats was studied on conscious rats with either one submaxillary gland chronically cannulated or both submaxillaries ligated. 2. During heat stress (40 degrees C) acclimated rats showed a decrease both in rectal temperature threshold for salivation (Tre-TS), in salivary flow rate and in Tre (hyperthermic plateau). Animals survived for extended periods and rats with ligated glands survived 40% less than non-ligated rats. 3. For both cannulated and ligated rats short term acclimation (5 days) was the most effective. 4. It is suggested that earlier activation of salivation mechanism is associated with the decreased hyperthermic plateau and that the decreased salivary flow rate allows better control of water balance of the animals. Consequently, survival period during heat stress is extended.

Acclimatization↗
PubMed1979

[Primary malignant tumour of the liver associated with the ingestion of oral contraceptives (author's transl)].

A 42-year-old woman, who had been taking oral contraceptives for 10 years, developed a primary carcinoma of the liver. The diagnosis was made by biopsy under laparoscopic control. Twenty one cases have already been reported in the literature. The aetiological role of contraceptives in the development of generally benign (approximately 200 published cases) and sometime malignant hepatic lesions, has not been definitely proven. The regression of certain benign tumours when contraceptives are stopped is the essential argument. In some patients, the association of benign lesions and of hepatic carcinoma suggests a single pathogenesis. The early recognition of such lesions justifies their being sought routinely in patients taking oral contraceptives (palpation of the liver, questioning concerning pain in the hepatic region). A national register will be required in order to determine their exact prevalence.

Adult↗
PubMed1977

[Virilizing tumours of the adrenal cortex with unimpaired menstruation (author's transl)].

Virilizing adenomas of the adrenal cortex entail, typically, hirsutism, amenorrhea and hypertrophy of the clitoris. We report two cases of adrenal adenoma, both revealed by hirsutism and significant biological features, but both without any alteration of the menstrual cycle. One of our 2 patients showed moderate hypertrophy of the clitoris. In the first patient, the tumour has been located thanks to dexamethasone--modifiying adrenal secretion, and in the second patient, thanks to angiography. These two cases reported are a warning never to neglect more hirsutism, even, when unobstrusive, and always to undertake minimal hormonal investigations.

Adenoma↗
PubMedDate not supplied

[A case of regressive Riedel's thyroiditis (author's transl)].

Riedel's struma is one among the locations of an invasive fibroinflammatory and sometimes multifocal process, of unknown etiology. This disease is extremely rare. The authors report a further case in a 41 year old man who had been developing a woody goiter for 3 months. Laboratory investigations showed normal inflammation tests, high rates of antithyroid antibodies and mild hypothyroidism. A surgical operation only consisted in a biopsy, which revealed typical histological features. The only treatment used was a suppletive therapy. During the evolution, antithyroid antibodies progressively decreased, hypothyroidism moderately increased and, chiefly, the goiter completely disappeared after 18 months. To our knowledge, regressive evolution was reported in very few cases after corticoid therapy, but never spontaneously.

Adult↗
PubMedDate not supplied

[Four-year follow-up of thyrotoxic patients treated with antithyroid drugs bases on thyroid suppressibility-Prognostic value of the 20-min 131-I thyroid uptake (author's transl)].

Out of 77 thyrotoxic patients treated with Carbimazole (30-15 mg/day) in combination with 1-triiodothyronine (75 micron/day) for 5-48 months applying 20-min 131I-thyroid uptake test at the end of treatment as a parameter for thyroid suppressibility, 39 cases (51%) have maintained euthyroid state for more than 4 years, while 20 (26%) relapsed within 3 months and the remaining 18 (23%) recurred within 6 years after antithyroid-drug (ATD) therapy. The predictable value of 20-min 131I-thyroid uptake was useful for distinguishing relapses from others, but there was no statiscally significant difference between recurrent cases and remittent ones. Since the negative correlation between the 20-min 131I-thyroid uptake and the recurrent phase was noted, the continuation of ATD therapy until the uptake reaches below 8% postpones this phase of recurrence.

Adult↗