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William Molloy

Publications and source records attributed to William Molloy.

4 recordsLinked to original sources

Lack of association between vascular dementia and Chlamydia pneumoniae infection: a case-control study.

BACKGROUND: Chronic inflammation appears to play a role in the pathogenesis of vascular dementia. Given the association between Chlamydia pneumoniae and stroke, the possibility exists that previous exposure to C. pneumoniae may play a role in vascular dementia. The objective of this study was to determine if there was an association between serological evidence of C. pneumoniae infection or inflammatory markers with vascular dementia. METHODS: 28 case-patients with vascular dementia at a geriatric clinic and 24 caregiver-controls were tested for C. pneumoniae IgG and IgA antibodies. The association between vascular dementia and C. pneumoniae titres as well as inflammatory markers was estimated by using both conditional logistic regression and stratified logistic regression. RESULTS: When matched cases were compared to controls, there was no significant difference in elevated C. pneumoniae specific IgG antibodies (titre >or= 1:32), odds ratio [OR] 1.3 (95% confidence intervals [CI] 0.3 to 6.0), p = 0.71, or in elevated C. pneumoniae specific IgA antibodies (titre >or= 1:16), OR 2.0 (95%CI 0.5 to 8.0), p = 0.33 indicative of past or persistent C. pneumoniae infection. Similarly, no difference in high IgG or IgA antibody levels (IgG titre >or= 1:512 or IgA titre >or= 1:64) between the two groups, indicative of recent C. pneumoniae infection, was found, OR 0.4 (95%CI 0.1 to 2.1), p = 0.27. For C-reactive protein (CRP), the mean difference between 18 matched pairs (case - control) was - 3.33 mg/L. There was no significant difference between cases and controls when comparing log transformed values, OR 0.03 (95%CI 0.00 to 2.89), p = 0.13 or comparing CRP values above or below the median, OR 0.8 (95%CI 0.2 to 3.4), p = 0.71. For fibrinogen, the mean difference between pairs (case - control) was -0.07 g/L. There was no statistical difference between cases and controls when comparing log transformed values, OR 0.6 (95%CI 0.0 to 31.2), p = 0.79 or between fibrinogen values above and below the median, OR = 0.5 (95%CI 0.1 to 2.0), p = 0.50. CONCLUSION: We found no evidence for a significant association between C. pneumoniae infection, inflammatory markers such as CRP and fibrinogen, and vascular dementia.

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Assessing the quality of drug detailing.

This study measured the validity of a new instrument, the Assessment Instrument for Drug Detailing (AIDD), used by doctors to score the quality of drug detailing provided by pharmaceutical representatives in their offices. Five pharmaceutical representatives provided "good, medium, and poor" details to 135 family doctors in their offices, who were blinded to the quality of the details. A "reference standard group" constructed the details and trained the representatives. An "assessment group" trained family physicians to use the AIDD to score the details. Physicians discriminated between different quality details in all but one domain, nomenclature (P </=.001). Physicians scored good quality presentations 2.3 points higher than poor quality details, and reported that they learned more from good than poor quality details. Approximately 71% of the variability in physicians' global ratings (R(2) = 0.71) was explained by assigned detail quality, F(2, 118) = 54.64, P <.0001, presentation time, F(2, 118) = 9.98, P <.0001, pharmaceutical representative, F(4, 118) = 9.58, P <.0001, and physician rating the detail, F(109, 118) = 1.94, P <.0001.

Analysis of Variance↗

Describing cognitive decline of patients at the mild or moderate stages of Alzheimer's disease using the Standardized MMSE.

OBJECTIVE: To describe the progression of patients with mild or moderate Alzheimer's disease (AD) to a severe stage using the Standardized Mini-Mental State Examination (SMMSE). METHODS: A cohort of 206 patients was stratified according to their baseline SMMSE scores: mild (19-24) and moderate (10-18). Proportional hazards analyses were used to determine the hazard of switching into a severe stage, defined as SMMSE score < 10. RESULTS: Among patients at the mild stage, 25% reached the severe stage within 2.6 years, and in the moderate group within 1.5 years. Patients with hallucinations at the mild stage experienced more rapid decline. The previous rate of decline was also found to be an important predictor. At the moderate stage, key predictors were lower SMMSE score and longer time since onset. CONCLUSIONS: Current SMMSE scores with other clinical details can be used to advise patients and caregivers about the expected progression of AD.

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