Behavioral and psychological signs of dementia (BPSD) are common clinical characteristics of Alzheimer's disease (AD). They result in patient and caregivers distress, decreased quality of life and placement in nursing homes. Treatment of BPSD with antidepressant and antipsychotic medications is not without complications and serious adverse effects. The acetylcholinesterase inhibitors (AChEI) show preliminary promise as psychotropic agents possibly able to improve BPSD in AD patients. The present study aimed to evaluate the effect of donepezil (an AChEI) as an only treatment for AD patients with BPSD. Ten consecutive AD patients hospitalized at a psychogeriatric ward due to BPSD were treated with donepezil for 24 weeks. Effect was measured using the NeuroPsychiatric Inventory (NPI). Significant reduction in the presence of delusions, irritability/lability and disinhibition were achieved after 24 weeks of donepezil treatment. This was accompanied by reduction in caregivers distress. The drug was well tolerated and all patients completed the study. Our findings complement the preliminary data that donepezil as well as other AChEIs are promising candidates for further study as psychotropic agents positively affecting BPSD in AD patients.

Journal Article↗

PubMedDate not supplied

Ocular Ferning test - effect of temperature and humidity on tear Ferning patterns.

BACKGROUND: The ocular ferning test is used as a diagnostic aid to evaluate patients with dry-eye disease. The ferning phenomenon is a dendritic growth form of dried tear fluid. The influence of temperature and relative humidity (rH) on the morphology of tear ferning patterns was investigated. METHODS: Two microliters of tear fluid of 5 volunteers with normal tear function were dropped onto a microscope slide with a pipette and were dried in a climatic chamber at four different temperatures (20, 22, 24 and 26 degrees C) and at four different grades of rH (30, 40, 50 and 60%) at each temperature. The dried droplet was divided according to distinct morphological features into a center, transition zone and margin. The center of the dried droplet was classified into four types according to the system of Rolando. RESULTS: In the temperature range between 20 and 26 degrees C, rH has a strong influence on the ferning patterns. At these temperatures, increasing rH resulted in a deterioration of type I ferning obtained at 30% rH to type II or type III at 60% rH in all subjects. Otherwise, at rH of 30, 40 and 50%, no definite influence of temperature between 20 and 26 degrees C was observed. At an rH of 60%, the ferning patterns changed with increasing temperature from 20 to 26 degrees C from type II to type III. CONCLUSION: High humidity can modify and deteriorate the ferning patterns of tear fluid from subjects with normal tear function. To obtain reproducible results using the ocular ferning test, stable conditions are necessary. An rH not higher than 50% at a temperature range between 20 and 26 degrees C produced ferning patterns without interstitial spaces which could be related to the best quality according to the system of Rolando.

Adult↗

PubMedDate not supplied

The malignant degeneration of a rectal neurinoma; "views on the tendency of the tumors of the nerve sheaths towards malignant degeneration".

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Female↗

PubMedDate not supplied

Secretoneurin in carcinoids of the appendix-immunohistochemical comparison with chromogranins A,B and secretogranin II.

BACKGROUND: The aim of the present study was to investigate immunohistochemically the distribution of secretoneurin, a novel 33 amino acid peptide, in comparison to chromogranin A, chromogranin B, and secretogranin II in carcinoids of the appendix. MATERIALS AND METHODS: Paraffin-embedded tissues from 47 carcinoids were incubated with antibodies specific for chromogranin A, chromogranin B, the secretogranin II derived peptide LF- 19, and secretoneurin. RESULTS: 44 tumors (94%) were positive for secretoneurin, whereas only 39 tumors (83%) were immunoreactive for chromogranin A. There was no significant correlation between neuropeptide expression and type of carcinoid, tumor size, vascular infiltration, serosal involvement or mesoappendiceal infiltration. CONCLUSIONS: Our investigations revealed that secretoneurin is detected more frequently than chromogranin A in carcinoids of the appendix. This supports the theory that tumor cells of appendiceal carcinoids are of a different origin than other midgut carcinoids. No special tumor entity with a characteristic secretoneurin-chromogranin pattern could be identified.

Antigens, CD↗