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Biomedical subjects

A Burns

Publications and source records attributed to A Burns.

At least 181 records · Page 10Linked to original sources
PubMed1990

Cause of death in Alzheimer's disease.

Bronchopneumonia was the commonest cause of death in 84 elderly patients suffering from Alzheimer's disease. The cause of death as stated on the death certificate agreed with the pathological diagnosis in 77% of cases. In 30%, no mention of the presence of a dementia syndrome was recorded on the death certificate. An increased willingness to record the presence of a dementia syndrome and a higher autopsy rate would increase the accuracy of death certification in Alzheimer's disease.

Aged↗
PubMed1990

Clinical assessment of irritability, aggression, and apathy in Huntington and Alzheimer disease.

Thirty-one patients with Alzheimer disease (AD) and 26 patients with Huntington disease (HD) were assessed using new scales to measure apathy and irritability. An existing scale was used to assess aggression. A similar prevalence of apathy and irritability was found in the two groups. The HD patients were more aggressive than the AD patients. In a subsample of the two groups, matched for degree of cognitive impairment, the HD patients were found to be more apathetic than the AD group. Irritability was related to be the premorbid trait of "bad temper" in HD but not in AD. There was no interrelationship among the three symptoms in either group. The scales for irritability and apathy have both interrater and test-retest reliability. They are able to differentiate patients with AD and HD from normal, disease-free control subjects. The usefulness of these scales, in relation to preexisting scales, is discussed.

Affect↗
PubMed1990

Dopexamine: studies in the general intensive care unit and after liver transplantation.

1. It has been suggested that the use of dopaminergic agents in the critically ill patient may reduce the incidence of renal failure and hence mortality. 2. Dopexamine hydrochloride is a new synthetic catecholamine. Like dopamine, it stimulates dopaminergic receptors. It also stimulates beta 2-adrenoceptors. Unlike dopamine, dopexamine has minimal effect at beta 1-adrenoceptors and no alpha-adrenoceptor activity. 3. Stimulation of renal dopaminergic and beta 2-adrenoceptors independently results in dilation of the renal vasculature. A natriuresis and diuresis is also promoted by dopaminergic stimulation. 4. A comparison between the administration of low dose dopamine and dopexamine in patients undergoing orthotopic liver transplantation resulted in less renal impairment and failure in the dopexamine group, although this did not achieve statistical significance. 5. Dopexamine elimination is reduced in the absence of hepatic function. 6. A patient with terminal liver failure was treated with dopexamine and although oxygen delivery was unchanged, oxygen consumption doubled. This suggests that dopexamine affects other organs as well as the kidneys.

Critical Care↗
PubMed1990

Psychiatric phenomena in Alzheimer's disease. I: Disorders of thought content.

In a sample of 178 subjects with Alzheimer's disease, diagnosed by clinical criteria (NINCDS/ADRDA), delusions had occurred in 16% of the sample since the onset of the illness and been present within the last 12 months in 11%. Simple delusions of theft and suspicion were the most common types and a greater proportion of men suffered delusions of theft. Subjects with other types of delusion had relatively well preserved lateral ventricular size and basal ganglia calcification. Twenty per cent of the group had experienced persecutory ideation short of delusions since the onset of the illness. Cognitive function at entry to the study and cognitive deterioration over the succeeding 12 months was not influenced by the presence of disorders of thought content.

Aged↗
PubMed1990

Psychiatric phenomena in Alzheimer's disease. II: Disorders of perception.

In a sample of 178 patients with AD, visual hallucinations had been experienced by 13% and auditory hallucinations by 10%. Thirty per cent had misidentification syndromes; these were associated with a younger age and younger age at onset of illness, and proportionally more men than women were affected. There was a reduced 30-month mortality rate in this group. Subjects with hallucinations had a greater deterioration in cognitive function at 12-month follow-up, which could not be accounted for by neuroleptic medication.

Aged↗
PubMed1990

Psychiatric phenomena in Alzheimer's disease. III: Disorders of mood.

Of 178 patients with AD, at least one depressive symptom was reported by 63%, 24% were rated as being depressed by a trained observer, and 43% were considered depressed by their relatives. Ten per cent had a previous history of depression. Elevated mood was rare, occurring in only six patients (3.5%). Subjects with depressive symptoms had less cognitive impairment and less ventricular enlargement on CT compared with those without symptoms. Widening of the interhemispheric fissure was associated with symptoms of mania but was inversely related to presence of depressive symptoms.

Aged↗
PubMed1990

Psychiatric phenomena in Alzheimer's disease. IV: Disorders of behaviour.

Out of a sample of 178 patients with AD, aggression was present in 20%, wandering in 19%, binge-eating in 10%, hyperorality in 6%, urinary incontinence in 48%, and sexual disinhibition in 7%. Behavioural abnormalities were greater in those with more severe dementia. Temporallobe atrophy correlated with aggression, and widening of the third ventricle with hyperorality. Features of the Kluver-Bucy syndrome were commonly seen, but the full syndrome occurred in only one subject. Patients with at least one feature of the Kluver-Bucy syndrome had greater temporal-lobe atropy than those without any of the features.

Adult↗
PubMed1990

Clinical features of patients attending a gender-identity clinic.

Of 106 patients attending a gender-identity clinic, 73% satisfied DSM-III criteria for transsexualism. These DSM-III positives had a significantly younger age of onset and were less likely to experience sexual arousal with cross-dressing than those who did not satisfy DSM-III criteria. They were also significantly more likely to fulfil a definition of 'core transsexualism'. 'Core transsexualism' may represent a subgroup within DSM-III criteria for transsexualism and its defining features in this study were an early age of onset, low sexual activity, lack of sexual arousal with cross-dressing and homosexual orientation. Of the whole sample, 23% were referred for gender reassignment surgery, of whom 100% were DSM-III positive and 60% were 'core transsexuals'.

Adult↗
PubMed1989

Dietary intake and clinical, anthropometric and biochemical indices of malnutrition in elderly demented patients and non-demented subjects.

Anthropometric and biochemical indices of nutritional status and weighed dietary intake have been studied in hospitalized patients with senile dementia, demented patients living in the community and age-matched control subjects who were not cognitively impaired. Demented patients were lighter than control subjects, and had a lower body mass index, skinfold thickness, mid-arm circumference and arm muscle bulk. The hospitalized patients were more seriously affected than those living in the community, and body weight was significantly negatively correlated with duration of hospitalization. Over a 6-month period the hospitalized patients showed a further weight loss, while those living in the community did not. Both groups of demented patients had higher intakes of energy, protein, vitamins and minerals than the control subjects. The diet of the hospitalized patients was slightly, but not significantly, superior to that of the patients living in the community. Biochemical evidence of specific vitamin inadequacy was equally prevalent in all three groups of subjects, and there were no significant correlations between the degree of cognitive impairment or behavioural disorder and any of the indices of nutritional state. Clinical signs suggestive of malnutrition were not correlated with either biochemical evidence of deficiency or cognitive impairment and behavioural disturbance.

Aged↗
PubMed1989

Structural brain CT changes and cognitive deficits in elderly depressives with and without reversible dementia ('pseudodementia').

Twenty-six elderly (greater than 60 yrs) patients with DSM-III major depression were compared to 13 patients with NINCDS/ADRDA probable Alzheimer's disease (AD), and to 31 screened normal controls. Subjects were matched on age and sex. Fifteen of the 26 depressed patients were cognitively impaired on the Mini-Mental State Examination (MMSE) upon admission, but after treatment returned to the normal range. These 15 patients were defined as having the dementia syndrome of depression (DOD). The remaining 11 depressed patients were termed depressed, cognitively normal (DCN). All subjects received standardized cranial CT scans for assessment of ventricular brain ratio (VBR) and CT attenuation numbers. Subjects also received neuropsychological evaluation. CT values for the 26 depressed patients lay between those of AD patients and normal controls. CT values for the DOD subgroup clustered near those of AD patients. Patterns of cognitive deficits and correlations of CT attenuation values with cognitive measures were also similar in AD and DOD. Most patients were reassessed at a mean of two years after initial testing; of the 11 of the 15 DOD re-examined, only one had undergone cognitive decline. By contrast, all AD patients retested had declined significantly. Episodes of DOD and DCN tended to 'breed true'. This study suggests that while patients with DOD may have underlying structural brain abnormalities, obvious short-term progression to AD does not commonly occur.

Aged↗
PubMed1989

The investigation of Alzheimer's disease with single photon emission tomography.

Twenty patients satisfying standard clinical criteria for Alzheimer's disease (AD) and six age-matched normal controls were studied using 99mTc hexamethyl-propyleneamine oxime and single photon emission tomography. The AD patients had lower regional cerebral blood flow (rCBF) in the temporal and posterior parietal lobes compared to controls. AD patients with apraxia and aphasia had lower rCBF in the lateral temporal and posterior parietal lobes than AD patients without these features. Within the AD group, correlations were found between neuropsychological tests and rCBF: praxis correlated with posterior parietal activity, memory with left temporal lobe activity and language with activity throughout the left hemisphere.

Aged↗
PubMed1989

Season of birth in Alzheimer's disease.

Variation in quarter of birth was examined in patients with a clinical diagnosis of AD. There was a significant excess of first-quarter births among AD patients as compared with the expected birth rates derived from an age-matched census sample. This finding was due entirely to the significant excess of first-quarter births in AD patients without a family history of dementia. No seasonal variation was found in the birth dates of other clinical groups.

Age Factors↗
PubMed1989

Dexamethasone-suppressible hyperaldosteronism: a large new kindred.

Dexamethasone-suppressible hyperaldosteronism (DSH) is a rare familial variety of primary aldosteronism in which the biochemical features of mineralocorticoid excess are corrected by treatment with glucocorticoids. We report a large new kindred with this syndrome, the second such family described in the British Isles and the first in Ireland. The family has a dramatic history of premature cardiovascular death. We have documented DSH in four members and found evidence of aldosterone excess in two others. The kindred is unique in that we have documented DSH in distant relatives (fourth cousins). All patients described are well controlled on potassium-sparing diuretics. Our report underlines the importance of a detailed family history in the assessment of hypertension due to primary aldosteronism.

Adolescent↗
PubMed1988

CBF tomograms with [99mTc-HM-PAO in patients with dementia (Alzheimer type and HIV) and Parkinson's disease--initial results.

We present preliminary data on the utility of functional brain imaging with [99mTc]-d,l-HM-PAO and single photon emission computed tomography (SPECT) in the study of patients with dementia of the Alzheimer type (DAT), HIV-related dementia syndrome, and the "on-off" syndrome of Parkinson's disease. In comparison with a group of age-matched controls, the DAT patients revealed distinctive bilateral temporal and posterior parietal deficits, which correlate with detailed psychometric evaluation. Patients with amnesia as the main symptom (group A) showed bilateral mesial temporal lobe perfusion deficits (p less than 0.02). More severely affected patients (group B) with significant apraxia, aphasia, or agnosia exhibited patterns compatible with bilateral reduced perfusion in the posterior parietal cortex, as well as reduced perfusion to both temporal lobes, different from the patients of the control group (p less than 0.05). SPECT studies of HIV patients with no evidence of intracraneal space occupying pathology showed marked perfusion deficits. Patients with Parkinson's disease and the "on-off" syndrome studied during an "on" phase (under levodopa therapy) and on another occasion after withdrawal of levodopa ("off") demonstrated a significant change in the uptake of [99mTc]-d,l-HM-PAO in the caudate nucleus (lower on "off") and thalamus (higher on "off"). These findings justify the present interest in the functional evaluation of the brain of patients with dementia. [99mTc]-d,l-HM-PAO and regional cerebral blood flow (rCBF)/SPECT appear useful and highlight individual disorders of flow in a variety of neuropsychiatric conditions.

Acquired Immunodeficiency Syndrome↗