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The pharmacological effects of buflomedil in patients with multi-cerebral infarcts dementia: an open, preliminary assessment.

The influence of buflomedil on brain circulation was investigated in an open, preliminary trial in 12 patients with dementia caused by multi-cerebral infarcts. Patients were given 150 mg buflomedil 3-times daily for a period of 6 months. Assessments carried out before treatment included regional cerebral blood flow measurements, using a 133Xenon technique, as well as psychometric tests (Weschler and Benton), psychiatric and neurological evaluations, and routine clinical and laboratory (blood and urine) examinations. The tests and investigations were repeated on Days 90 and 180 of treatment. The results showed that mean regional cerebral blood flow increased by 15% to 22% and 16% to 24% in the right and left hemispheres, respectively, by the end of the trial, and marked improvements were noted in psychiatric symptoms and scores in the psychometric tests. A controlled, double-blind study is being planned to validate these preliminary findings.

Aged↗

Relationship between insight, educational background and cognition in schizophrenia.

BACKGROUND: There is a paucity of research into the relationship between insight and variables including cognitive function, educational background and symptomatology in schizophrenia. METHOD: Sixty-four patients with DSM-III-R diagnosis schizophrenia were assessed with the Schedule for Assessment of Insight, Mini Mental State cognitive test, a new measure of knowledge about treatment (the Understanding of Medication Questionnaire), and educational background and compliance assessments. RESULTS: Insight scores correlated significantly with a range of variables. In a multiple regression analysis only knowledge about treatment and number of years in education explained a significant proportion of insight. CONCLUSION: Educational background and the intellectual ability required to learn complex concepts, such as models of mental illness, appear to be more important than previously considered. Research is limited by the lack of a generally accepted definition of insight.

Adult↗

Choline kinase: a novel target for antitumor drugs.

Malignant cells are characterized by the accumulation of genetic alterations, which result in the disregulation of signal transduction pathways that control proliferation, differentiation and apoptosis. The identification of the molecular components involved in these aberrant processes is necessary for the development of chemotherapeutic interventions to restore or selectively destroy the transformed cells. Discovery of new chemotherapeutic agents is probably one of the most reliable ways to improve our success against cancer, and intelligent drug design is a key factor to achieve this goal. Thus, the identification of novel targets for anticancer drug discovery is needed. This review provides evidence to support choline kinase as one such target.

Journal Article↗

[Modified sanjiasan decoction in regulating intelligence state of patients with vascular dementia].

OBJECTIVE: To investigate the therapeutic effects of modified Sanjiasan decoction (MSD) on vascular dementia (VD). METHODS: Thirty-seven patients in the treated group were given MSD, one dosage each day, and 31 patients in the control group were administered orally Naofukang 0.8 g three times a day. The treatment course for both groups was three months. The indices as Hasegawa dementia scale (HDS), mini mental state examination (MMSE) and its subentries, intelligence quotient (IQ) and memory quotient (MQ) were examined. RESULTS: MSD could improve the scores of HDS, MMSE and its subentries (P<0.05 or P<0.01), ameliorate dementia state and enhance IQ (P<0.05) and MQ (P<0.01) in patients with VD. CONCLUSION: MSD has a certain effect on intelligence benefiting and dementia antagonizing.

Aged↗

Clinical overview of typical Mycoplasma pneumoniae infections.

A number of clinical and epidemiological factors permit the tentative identification of Mycoplasma pneumoniae infections. These selective factors can be considered the mainstay of diagnosis because they facilitate intelligent and efficient use of laboratory tests. The laboratory, in turn, through identification of the causative agent, augments both clinical and epidemiological data. The laboratory can better serve its purpose as more rapid, sensitive, and specific diagnostic methods come into use.

Community-Acquired Infections↗

Familial hyperinsulinism: successful conservative management.

A large family in whom 4 of 13 children were affected with hyperinsulinism of variable severity is described. The oldest affected child required subtotal pancreatectomy to control the hypoglycemia, but the three younger children were managed successfully with prolonged conservative therapy with maintenance oral doses of diazoxide. The three affected school-age children in the family have deficits in the areas of visuomotor integration and short-term memory. The three youngest children have normal intelligence compared with four unaffected siblings; only the oldest child, who has undergone pancreatectomy, has low-average intelligence (IQ80). We conclude that in infants with persistent but asymptomatic hyperinsulinemic hypoglycemia every effort should be made to treat conservatively with antihypoglycemic agents such as diazoxide for as long as possible to allow for spontaneous remission and thereby avoid pancreatectomy.

Adolescent↗

The moral responsibility of the hospital.

The hospital has legal liability. Does it also have moral responsibility? Is it a moral agent, and if so in what sense? There are two issues involved, one conceptual and the other normative. The conceptual issue is whether a hospital can be morally responsible. If seen not only as a physical facility but as a formal organization, it can be said to act rationally, choose between alternatives, and affect human beings. It thus satisfies the criteria for moral responsibility, even though it is not a person. Though moral responsibility can be attributed intelligibly to a hospital, such responsibility can be assumed only by those within it who act for it. Such responsibility is agent responsibility and may be shared in a number of ways. Hospital responsibilities can be separated from the professional moral responsibility and the personal moral responsibility held by doctors, nurses, and others within a hospital. Assuming these three types of responsibility makes possible conflicts of responsibility for those who hold them. Normatively, the moral responsibility of the hospital is appropriately limited by its purpose and is primarily administrative. It has designatable moral responsibilities to its patients, doctors and nurses, and the public. These can be distinguished from the responsibilities of doctors and nurses to the public. The responsibility of a doctor on the hospital staff is different from the responsibility of a doctor who simply practices in the hospital; that of a staff nurse from that of a private nurse. The difference is in large part a function of the one sharing the responsibility of the hospital and the other not. An analysis of a hospital's moral responsibilities suggests structures appropriate to a hospital that wishes to meet its moral responsibilities.

Ethics↗

Course and outcome of drug abuse in military conscripts.

The course and outcome of drug abuse was studied by following a representative sample of military conscripts from Gothenburg who participated in a questionnaire survey concerning drug habits in 1969/70 in connection with registration for military service. Those with abuse registered in medical or social welfare files had, with few exceptions (11%), admitted to use of drugs in the questionnaire. However, 55% of those who in the questionnaire indicated high-frequency drug use and 89% of those who indicated low-frequency drug use were not registered. A large proportion of drug abuse was thus hidden. It was estimated that 6% of the whole population were registered for drug abuse up to the time of the questionnaire survey, and another 1% after that. In some cases registered drug abuse started as early as 9 years of age. For the under-fifteens solvents were the commonest first drug and for the over-fifteens cannabis. Few initiated drug abuse after the age of 20. In 30% of the registered men, the duration of abuse was less than or equal to 2 years, in 50% 2-10 years and in 20% less than or equal to 10 years. Distributed over the entire population, the proportions were 2%, 3% and 1%, respectively. Among high-frequency drugs users, 45% of the registered abuse remained after 5 years and 20% after 9 years. Compared with the drug-free "normal group" registered drug abusers had more often indicated running away from home, repeated truancy, nervous complaints, and had more often received child and youth psychiatric care and been registered with the Social Welfare Administration at an early age. Those who had long drug careers had lower intelligence levels than the normal group.

Adult↗

Classifying structural alterations of the cytoskeleton by spectrum enhancement and descriptor fusion.

A classifier capable of ranking structural alterations of the cytoskeleton is developed. Images of cytoskeletal microtubules obtained from the epifluorescence microscopy of primary culture rat hepatocytes are analyzed. Morphological descriptors are extracted by contour and mass fractal analysis, direct methods, and spectrum enhancement. All methods are designed and tuned to make the extracted morphological descriptors insensitive to absolute fluorescence intensities. Spectrum enhancement is a nonlinear filter that involves spatial differentiation of the gray-scale image followed by conversion of power spectral density to the logarithmic scale and averaging over arcs in the reciprocal domain. Enhanced spectra exhibit local maxima that correspond to the structured microtubule bundles of a normal cytoskeleton. Descriptor fusion for classification is achieved by means of multivariate analysis. The classifier is trained by image sets representing normal ("negative control") microtubules and those altered by exposure to a fungicide at the highest dose of the experiment design. Some sensitivity and validation tests, including discriminant functions analysis, are applied to the classifier. The latter is applied to recognize images of microtubules not used in the training stage and comes from treatments at lower concentrations and shorter times. As a result, structural alterations are ranked and structural recovery after treatment is quantified. The method has potential use in quantitative, morphology-based tests on the cytoskeleton treated either by anticancer drugs or by cytotoxic agents.

Algorithms↗

Representation in natural and artificial agents: an embodied cognitive science perspective.

The goal of the present paper is to provide an embodied cognitive science view on representation. Using the fundamental task of category learning, we will demonstrate that this perspective enables us to shed new light on many pertinent issues and opens up new prospects for investigation. The main focus of this paper is on the prerequisites to acquire representations of objects in the real world. We suggest that the main prerequisite is embodiment which allows an agent--human, animal or robot--to manipulate its sensory input such that invariances are generated. These invariances, in turn, are the basis of representation formation. In other words, the paper does not focus on representations per se, but rather discusses the various processes involved in order to make learning and representation acquisition possible. The argument structure is as follows. First we introduce two new perspectives on representation, namely frame-of-reference, and complete agent. Then we elaborate the complete agent perspective and focus in particular on embodiment and situatedness. We argue that embodiment has two main aspects, a dynamic and an information theoretic one. Focusing on the latter, there are a number of implications: Representation can only be understood if the embedding of the neural substrate in the physical agent is known, which includes morphology (shape), positioning and nature of sensors. Because an autonomous mobile agent in the real world is exposed to a continuously changing high-dimensional stream of sensory stimulation, if it is to learn category distinctions, it first needs a focus of attention mechanism, and then it must have a way to reduce the dimensionality of this high-dimensional sensory stream. Learning is very hard because the invariances are typically not found in the sensory data directly--the classical problem of object constancy: it is a so-called type 2 problem. Rather than trying to improve the learning algorithms--which is the standard approach--the embodied cognitive science view suggests a different approach which focuses on the nature of the data: the agent is not passively exposed to a given data distribution, but, by exploiting its body and through the interaction with the environment, it can actually generate the data. More specifically, it can generate correlated data that has the property that it can be easily learned. This learnability is due to redundancies resulting from the appropriate interactions with the environment. Through such interactions, the former type 2 problem is transformed into a type 1 problem, thus reducing the complexity of the learning task by orders of magnitude. By observing the frame-of-reference problem we will discuss to what extent these invariances are reflected--represented--in the "neural substrate", i.e. the internal mechanisms of the agent. It is concluded, that representation is not a concept that can be studied in the abstract, but should be elaborated in the context of concrete agent-environment interactions. These ideas are all illustrated with examples of natural agents and artificial agents. In particular, we will present a suite of experiments on simulated and real-world artificial agents instantiating the main arguments.

Algorithms↗

Effects of phenothiazine drugs on serum levels of apolipoproteins and lipoproteins in schizophrenic subjects.

AIM: To investigate the risk factors and clinical significance of blood-lipid metabolic disorder in schizophrenic patients caused by phenothiazine treatment for long term (from 1 month to 25 years). METHODS: Serum levels of apolipoprotein AI (apoAI), apolipoprotein B (apoB), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and total cholesterol (TC) were measured in 120 chronic schizophrenia patients, 50 vascular dementia, and 100 normal controls by the enzyme method and immune fluoroscopy turbidimetric method. RESULTS: The patients with schizophrenia and vascular dementia had significantly lower content of apoAI, HDL-C, and apoAI/apoB than those in normal control (P<0.01). Their apoB and TG levels were higher than the healthy control group (P<0.01). The TG contents in the negative group and the vascular dementia group were obviously higher than the positive group (P<0.01) while there was no marked difference between the TC levels in the three groups and the normal control group (P>0.05). CONCLUSION: The chronic schizophrenic patients have a blood-lipid metabolic disorder by long-term intake of phenothiazine drugs. It is suggested that the traditional treatment with antipsychotic should reformed, and that drugs of degrading lipid and coagulation should be used to prevent and reduce the risk factors causing the onset of cardiovascular and cerebrovascular diseases and delay the development of the disturbance of intelligence and dementia.

Adolescent↗

Possible association of interleukin-2 treatment with depression and suicide.

Immunomodulatory agents for the treatment of certain oncologic disorders are rapidly moving from the research laboratory into clinical practice. These agents may not be void of potential neuropsychiatric sequelae. The following clinical report concerns a previously nondepressed patient with no history of psychiatric disorders who became depressed and killed himself while being treated with interleukin-2. It is important that consulting psychiatrists be sensitive to acute emotional changes in cancer patients taking immunomodulatory agents.

Depression↗

Relationship of emotional intelligence and adherence to combination antiretroviral medications by individuals living with HIV disease.

Medications are an intentional and purposeful means to the successful management of many chronic diseases. In the treatment of disease caused by HIV, adherence to medication is of particular concern because any level of nonadherence, often a few missed doses, will lead eventually to the development of drug resistance. Many predictors of poor adherence to HIV medications have been identified as significant factors in adherence. Among these is the emotional aspect. The purpose of this study was to examine emotional intelligence (EI) and adherence to combination antiretroviral therapy in individuals who are infected with HIV. EI is defined as the ability to perceive and express emotions, facilitate emotions, understand and reason with emotion, and manage emotions. EI has been correlated with various aspects of success in life. In this study, EI was measured by the Mayer, Salovey, Caruso Emotional Intelligence Test. Adherence to medications was measured by self-report and defined as less than 10% missed doses of medications. Eighty-two participants were recruited from an urban hospital-based HIV clinic. Pearson's r was used to analyze the data for significance, and no correlation was reported. This data set was not large enough to prove significance, statistically, of the research question. However, an unexpected result of this study was that the overall EI scores for this particular population were markedly lower than the test norms. Further study would be warranted and recommended to explore El measurement in people at risk for HIV disease or in those who have the disease to further understand the impact of emotions and EI in this specific population.

Adult↗

Neuropsychological functioning in a cohort of HIV- and hepatitis C virus-infected women.

OBJECTIVE: To evaluate the neurocognitive function in 220 women enrolled in the Women's Interagency HIV Study (WIHS), a study of disease progression in women living with HIV/AIDS and in HIV-negative controls. METHODS: We evaluated the prevalence of abnormal neuropsychological (NP) results in hepatitis C virus (HCV)-positive compared with HCV-negative women in combination with HIV serostatus. RESULTS: NP impairment was significantly higher for HCV-positive women in comparison with HCV-negative women [odds ratio (OR), 2.03; 95% confidence interval (CI), 1.17-3.51]. Women co-infected with HCV and HIV demonstrated greater abnormal NP performance than those not infected with either, particularly if there was evidence of CD4 T-lymphocyte immunosuppression [> 200 x 10(6) CD4 cells/l (OR, 3.48; 95% CI, 1.49-8.15) and < or = 200 x 10(6) CD4 cells/l (OR, 5.38; 95% CI, 1.46-19.84)]. Women who were HCV-positive/HIV-positive and not taking antiretroviral therapy (ART) were more likely (OR, 7.03; 95% CI, 2.63-18.82) to demonstrate NP impairment than those who were HCV-negative/HIV-negative. In analyses controlling separately for education, intelligence quotient, depression, sedating drug use, head injury, ethnicity, and history of substance use, HCV continued to significantly predict NP impairment. The HCV effect did not reach significance when controlling for age in bivariate or multivariate analyses although the odds ratio for NP abnormalities in HCV-infected patients was only slightly reduced (ORs above 1.9). After testing for an interaction between age and infection status, we conducted age-stratified analysis and showed a significant effect of infection status for those aged under 40 years. CONCLUSIONS: The effect of aging on co-infected populations will require further study. This study has demonstrated the association of HCV with the risk of neurocognitive impairment in women living with HIV/AIDS and suggests that co-infection has an additive effect.

Adult↗

Long-term beneficial effects of dexamethasone on intellectual and neuropsychological outcome of children with pneumococcal meningitis.

A Substantial ratio of bacterial meningitis survivors suffers mild or serious intellectual and neuropsychological handicaps. We organized eighty subjects into three groups: 1) Pneumococcal meningitis (PM) who did not receive dexamethasone, 2) PM who received dexamethasone, 3) Other bacterial meningitis with different etiology. All subjects underwent Bender Visual Motor Gestalt test and age-appropriate Intelligence quotient (IQ) tests. The mean full-scale IQ scoring fell within normal range (90+/-17) in the post-meningitic cohort. There was no statistical difference between two pneumococcal groups regarding full scale IQ testing (88+/-16 and 91+/-18) and Bender-Gestalt scoring (4.0+/-3.3 and 3.8+/-2.6), respectively. However, the subjects with full scale IQ score <85 (below the average) were statistically less in the group with steroid therapy. PM patients who received dexamethasone therapy had statistically better academic performance. As a result, adjuvant steroid therapy has no significant impact on overall intellectual tests in PM subjects. However, dexamethasone seems to diminish development of below the average IQ scoring in PM cases. In addition, PM subjects who received steroids showed better academic achievement. These findings may support the idea of dexamethasone administration prior to first antibiotic dose in PM subjects.

Adolescent↗