[Clinical diagnosis of Alzheimer's disease].
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Biomedical subjects
Publications and source records attributed to B Romero.
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Somatostatin binding sites were characterized in isolated rat adipocytes. The binding was found to be saturable, reversible, and time- and temperature-dependent. The somatostatin binding sites are principally located on the cell surface. 125I-[Tyr11]somatostatin binding was not inhibited by glucagon and angiotensin II. By contrast, native somatostatin and somatostatin-28 displaced labeled peptide with a similar ED50: 50 nM. Scatchard analysis pointed to the existence of two classes of binding sites, with a Kd of 7.64 nM for the high-affinity sites and a Kd of 295 nM for the low-affinity ones. Comparison of somatostatin receptor binding and its lipolytic action in isolated rat adipocytes suggested that the spare receptor phenomenon cannot be applied to the lipolytic action of somatostatin in rat adipose tissue.
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In a case of severe aphasia it was attempted to use a mediation technique. During several months there was no improvement in speech by using the usual techniques. The patient had to learn several gestures that corresponded to different letters. This technique result in a considerable speech improvement. It is discussed which mechanisms are possibly involved in the rehabilitation process; the practical importance of the mediation technique is suggested.
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This study of 200 Uruguayans between 0 and 86 years old was designed to determine the prevalence of lactose malabsorption. Lactose intolerance is defined as a clinical syndrome of abdominal pain, diarrhea, flatulence, and bloating after the ingestion of a standard lactose tolerance test dose (2 g of lactose per kilogram of body weight or 50 g/m2 of body surface area, maximum 50 g in a 20% water solution). Lactose malabsorption refers to the state in which dietary lactose remains unhydrolyzed and subsequently unabsorbed from the gastrointestinal tract; symptoms may or may not result from lactose malabsorption. The technique of breath hydrogen (H2) was used after ingestion of 2 g/kg body weight to a maximum of 50 g in a 20% solution. There was no lactose malabsorption in children younger than 5 years old. The prevalence increases progressively after the age of 5, and in adolescence the percentage of malabsorption is similar to that in adults, who show 65% lactose malabsorption, with 25% asymptomatic and 40% intolerant. In 109 white adults, the prevalence of lactose malabsorption is 63%, with 24% asymptomatic and 39% intolerant. In 11 black adults, lactose malabsorption is 82%, with 27% asymptomatic and 55% intolerant. The difference between white and black adults is statistically significant (p less than 0.05). The H2 test is simple, reliable, noninvasive, and appropriate to study large populations.
This longitudinal study measured the rate of spontaneous speech decline in patients with Alzheimer's disease (AD) at a 1-year follow-up and determined the effect of clinical and demographic factors on that rate. In addition the pattern of spontaneous speech impairment was examined. The expected pattern of spontaneous speech impairment with prominent disturbances of communication and semantics, moderate disturbances of automatic speech, but with retained phonematic structures, was found at baseline and at follow-up in the majority of our rather large sample (n = 63). This result is discussed in terms of intrafunctional homogeneity and of selective involvement of neuronal systems in AD. There was a trend for a more rapid language decline in patients with a family history of dementia. No relationship was detected between the rate of spontaneous speech decline and other clinical and demographic factors, with the exception of initial spontaneous speech impairment.
Eighty-eight patients with mild to moderate dementia of the Alzheimer type were tested in a word list and a spatial pattern recall task. With increasing degree of dementia severity we found a decline in the initial recall scores while learning curves over five consecutive trials remained normal in the mildly demented patients. Furthermore, there was a loss of the primacy effect in the word list task in our moderately demented patients. These findings are consistent with the pattern that have been reported after medial temporal lobe dysfunction. The data are discussed in the framework of cognitive dual process theories of memory as indicators of a contextual retrieval deficit.
For the majority of demented elderly persons the family is the most important resource of support. Living with a demented family member lays a heavy strain on the care-givers. Appropriate counselling may reduce the care-givers' burden and enable them to be more effective. In the present report, some general guidelines of family support are proposed, summarising two years of experience in a special outpatient clinic for the demented elderly.