Search PubMed⌕ Search

Biomedical subjects

G A Broe

Publications and source records attributed to G A Broe.

At least 73 records · Page 4Linked to original sources
PubMed1990

A case-control study of Alzheimer's disease in Australia.

We conducted a case-control study of clinically diagnosed Alzheimer's disease (AD) on 170 cases aged 52 to 96 years, and 170 controls matched for age, sex and, where possible, the general practice of origin. Trained lay interviewers naive to the hypotheses and to the clinical status of the elderly person carried out risk-factor interviews with informants. Significant odds ratios were found for 4 variables: a history of either dementia, probable AD, or Down's syndrome in a 1st-degree relative, and underactivity as a behavioral trait in both the recent and more distant past. Previously reported or suggested associations not confirmed by this study include head injury, starvation, thyroid disease, analgesic abuse, antacid use (aluminum exposure), alcohol abuse, smoking, and being left-handed.

Aged↗
PubMed1989

Impairment after severe blunt head injury: the results from a consecutive series of 100 patients.

Three scales, assessing the degree of brain impairment after severe blunt head injury in neurophysical and neuropsychological functions as well as overall organic functioning, are described. A consecutive series of 100 severe blunt head injured patients was followed up 6 years post-trauma and the scales were used to measure the residual impairments and determine the level of recovery for 82 subjects in the series. No subject made a complete neurophysical and neuropsychological recovery, 92% of the series was classified as suffering clinically significant impairments and in half the series the moderate or severe impairments were consistent with a poor level of recovery. The impairments of a large proportion (42%) of the series, however, were classified as mild. Although most subjects demonstrated impairments in both neurophysical and neuropsychological functions, 43% of the series suffered isolated impairments in either the neurophysical or neuropsychological areas. There was strong agreement between the overall organic impairment profile and the subjects' classifications on the Glasgow Outcome Scale.

Adolescent↗
PubMed1989

Psychosocial outcome for the survivors of severe blunt head injury: the results from a consecutive series of 100 patients.

A consecutive series of 100 severely blunt head injured subjects was followed up six years after trauma and the level of psychosocial reintegration was determined for 87 subjects. Three-quarters of the series were classified as demonstrating major disability, having either a Poor Reintegration (33%) or a Substantially Limited Reintegration (43%); the remaining one-quarter of the series attained a Good Reintegration. The level of reintegration was related to the Glasgow Outcome Scale classification, although a one-to-one correspondence between the Glasgow Outcome Scale and the Psychosocial Disability Scale was not found: each of the Moderate Disability and Good Recovery groups was fairly evenly divided between a better and worse level of reintegration. Specific aspects of the subjects' psychosocial reintegration in employment, interpersonal relationships, functional independence, social contacts and leisure interests are described and the implications of the findings for the provision of extended care services to meet the long term needs are discussed.

Adolescent↗
PubMed1989

The Sydney Multicentre Study of Parkinson's disease: a report on the first 3 years.

One hundred and twenty nine de novo patients with idiopathic Parkinson's disease are being followed over a 5 year period in a double-blind multicentre study comparing low-dose bromocriptine (less than 30 mg/day) with low-dose levodopa-carbidopa (less than 600/150 mg/day). Sixty six patients have been randomised to bromocriptine and 63 patients to levodopa-carbidopa. Improvement has been greater in the levodopa-carbidopa group than in the bromocriptine group. Involuntary movements have so far only occurred in patients on levodopa-carbidopa, the incidence being much lower than is usually described with conventional doses. Mild, end-of-dose failure has occurred in both treatment groups; however, no patient has developed the "on-off" phenomenon. Low-dose levodopa-carbidopa appears to be a more effective anti-Parkinsonian treatment than low-dose bromocriptine but more prone to cause dyskinesia.

Adult↗
PubMed1989

Monozygotic twins discordant for Alzheimer's disease.

We identified 3 pairs of monozygotic twins discordant for probable Alzheimer's disease from a twin register and found no systematic differences in potential risk factor exposures between affected and unaffected twins. Such cases predict a role for environmental factors in the etiology or clinical onset of Alzheimer's disease.

Aged↗
PubMed1989

The neuropsychology of de novo patients with idiopathic Parkinson's disease: the effects of age of onset.

One hundred de novo patients with Parkinson's disease (PD) were classified into two groups according to age of onset of symptoms. Seventy two patients were under 70 years and 28 were 70 years and over. All patients were given neurological and neuropsychological assessments, and the severity of the signs was rated on a modified Columbia scale. The neuropsychological assessment was also administered to 50 age-and-education-matched controls. The neuropsychological test battery included tests of verbal learning, visual memory, verbal fluency, visuospatial skill, simple and choice reaction time, language and maze learning. The late-onset patients had significant impairment in nonverbal reasoning, auditory verbal learning, visual memory and choice reaction time in contrast to early-onset patients and controls. A relationship was found between bradykinesia and widespread cognitive impairment. Severity of tremor was found to be significantly correlated with impairment in auditory verbal learning, visual memory and increased choice reaction time, while rigidity was found to be associated with cognitive impairment in verbal fluency and visuospatial skill. Using DSM II criteria, 39% of the late-onset and 8% of the early-onset group were classified as demented. Dementia was more common in patients with bilateral symmetrical disease and in those patients with marked tremor and bradykinesia. The pattern of cognitive impairment in PD was consistent with that associated with a subcortical dementia. This study confirms that the expression of PD is markedly influenced by the age of onset.

Age Factors↗
PubMed1987

The Sydney multicentre study of Parkinson's disease. The first 18 months.

Low-dose bromocriptine therapy and low-dose levodopa-carbidopa therapy are being compared in a double-blind study over a five-year period as treatment for newly-diagnosed patients with Parkinson's disease. Ninety-four patients had entered the study by January 1986 and of these, 50 had been followed for six months or more. Preliminary results confirm that many patients with Parkinson's disease can be managed satisfactorily in the early stages of the disease with low-dose therapy. Three patients, all of whom were receiving levodopa-carbidopa therapy, developed dyskinesia. Twelve patients who had received bromocriptine had an inadequate response or developed confusion or postural hypotension. Of these patients, six had a poor response to subsequent levodopa-carbidopa therapy. While the initial improvement that results from low-dose bromocriptine therapy and low-dose levodopa-carbidopa therapy is less than one would expect with conventional doses of these agents, it is hoped that this approach will reduce the incidence of long-term side-effects such as dyskinesia and fluctuations.

Australia↗
PubMed1985

Neuropathological findings in a case of chronic inflammatory polyneuropathy.

A 52-year-old woman presented with increasing pain, weakness, and paraesthesiae of four months' duration in the lower limbs. She suffered from chronic obstructive airways disease and hypertension. Neurological examination revealed wasting of the quadriceps muscles, weakness of the lower limbs, and absent ankle jerks. The sensory examination was normal. Full blood count, ESR, biochemical, immunological, and viral studies, urinary heavy metal assays, and cerebrospinal fluid examination were normal. Nerve conduction studies were consistent with a sensorimotor neuropathy, and electromyographic sampling was consistent with acute denervation. A sural nerve biopsy showed axonal degeneration and segmental demyelination. One month after admission, she developed carbon dioxide retention. Her weakness spread to affect the upper limbs, and she could not be resuscitated after a cardiac arrest three months after admission. General autopsy examination revealed bronchopneumonia. Neuropathological examination showed a lymphocytic infiltrate in the nerve roots of the cauda equina, the lumbosacral plexus, and the sural and vagal nerves. Increased cellularity and collagen were evident in these nerves. A diagnosis of chronic inflammatory polyneuropathy was made. The neuropathology of this entity is discussed.

Brain↗
PubMed1985

Electronystagmogram is useful in the diagnosis of vertebrobasilar and carotid transient ischaemic attacks.

Electronystagmogram examination of patients with transient ischaemic attacks or infarcts in the carotid and vertebrobasilar system revealed significantly increased number of patients with reduced caloric response, abnormal optokinetic nystagmus, saccadic dysmetria and presence of central nystagmus in patients with ischaemia of the posterior circulation. Using the presence of such abnormality as criterion for confirming posterior circulation ischaemia in suspected cases, we have correctly identified 67% of cases of vertebrobasilar infarct, 44% of the transient ischaemic attacks, 83% of carotid infarct and 96% of the carotid transient ischaemic attacks. Electronystagmogram findings of brainstem/cerebrallar system abnormality were found in 36% of transient ischaemic attacks with vertigo, and 50% of infarcts associated with vertigo. Thus Electronystagmogram studies are useful in localising the site of lesion in patients with suspected vertebrobasilar disease or with ischaemic attacks of undetermined territory, and in differentiation of vertigo due to definite cerebrovascular disease from peripheral causes of vertigo.

Aged↗
PubMed1984

Chromosome fragility in Alzheimer's disease.

We present cytogenetic findings for 12 patients with Alzheimer's Disease (AD) mean age 75.8 +/- 6.01 years and 35 normal age and sex matched controls (mean age 74.8 +/- 4.04 years). The study, undertaken due to reports of increased fragments and chromosome breakage in individuals with AD, was performed blind on coded peripheral blood specimens and the allocation of AD or control was not known to the cytogenetic staff until the end of the study. Both the AD group and the controls have been very carefully selected and both underwent the same clinical assessment and screening procedures which included CT scanning. Chromosomes were analysed after 72 h cultures, using deprived medium TC199 which is known to enhance the appearance of fragile sites. A minimum of 50 cells was examined in each case and any rearrangement found was classified as ctg, csg , ctb , csb and the chromosome in which it occurred was recorded. Analysis of results showed that there was no statistically significant difference between the AD group and the controls for either the total occurrence of breaks, the type of aberration or the chromosome(s) involved. In both groups the commonest break was in 3p .

Aged↗
PubMed1983

Chromosome aneuploidy in Alzheimer's disease.

We present cytogenetic findings in 9 patients with Alzheimer's disease (AD) and 35 normal age matched controls. The study was undertaken due to reports of increased aneuploidy in individuals with AD. Coded peripheral blood chromosome preparations were evaluated for aneuploidy; there were 4.5% hypomodal cells in AD patients compared with 5.5% in controls. There were no hypermodal cells in the AD group and only 0.7% among the controls. Statistical analyses of the results did not show any differences between AD patients and controls in these data. There was a statistically significant increase in the loss of C group chromosomes in the old controls which we attribute to ageing.

Aged↗
PubMed1981

Gastric emptying rate in the elderly: implications for drug therapy.

The effect of the aging process on gastric emptying was studied in 11 elderly subjects (mean age, 77) and in 7 young healthy volunteers (mean age, 26). Gastric emptying rates were assessed by a modified sequential scinti-scanning technique after administration of the nonabsorbable chelated radiopharmaceutical 99mTc-DTPA. The rate of emptying, expressed as half-time (T 1/2e) in minutes, was significantly longer (p less than 0.001) in the elderly subjects (mean apparent T 1/2e = 123.23 min) compared to the young healthy volunteers (mean apparent T 1/2e = 49.69 min). Clinical implications of these findings are discussed, particularly with respect to the rate and extent of drug absorption in elderly persons.

Administration, Oral↗
PubMed1981

Gastric emptying rate and the systemic availability of levodopa in the elderly parkinsonian patient.

The gastric emptying rate and systemic availability of levodopa, administered as a single oral dose, was studied in six elderly parkinsonian patients, five elderly nonparkinsonian subjects, and six young healthy volunteers. In both elderly groups, gastric emptying was slowed relative to the young healthy volunteers. The lack of significant differences in the plasma elimination half-life of levodopa among the three groups was accompanied by increased absorption of the drug in the elderly patient groups. These findings are discussed in relation to a possible age-related alteration in the activity of peripheral dopa decarboxylase in the elderly parkinsonian patients.

Administration, Oral↗
PubMed1981

Senile Parkinsonism and dopa pharmacokinetics.

Senile Parkinsonism can be clinically differentiated from idiopathic Parkinson's disease in younger age groups. It has a slower clinical course, an altered therapeutic response and a more widespread neuropathology. The drug of choice for senile Parkinsonism is levodopa given in low starting daily doses of 100mg, with low increments of 100mg every 4 to 7 days and low maintenance doses of 0.5 to 2.5g daily. Increased absorption of a given dose of levodopa in the elderly explains in part the lower dosage requirements. Combined therapy with a peripheral decarboxylase inhibitor is usually unnecessary in the elderly and carries a higher risk of neuropsychiatric toxicity. The use of a peripheral decarboxylase inhibitor should be reserved for those few elderly patients with significant gastrointestinal side effects and for those who respond poorly to levodopa alone. Anticholinergic agents are in general contraindicated in the elderly, either used alone or in combination with levodopa.

Aged↗
PubMed1976

Neurological disorders in the elderly at home.

Eight hundred and eight subjects participated in three surveys of random samples of people aged 65 years or more living in their own homes. Neurological history and examination showed the prevalence of completed stroke to be 73 per 1000. Eighty-seven subjects per 1000 gave a history of transient cerebral ischaemic attacks. These prevalence rates were unaffected by age or sex. Senile dementia was diagnosed in 24 subjects per 1000 under 75 years and 109 per 1000 over that age. The prevalence of dementia of all types was 43 per 1000 under, and 140 per 1000, over 75 years of age. Parkinsonism was diagnosed in 16 subjects per 1000, and essential tremor in 17 per 1000. The prevalence of epilepsy was four subject per 1000. Other neurological disorders were diagnosed in 36 subjects, and a similar number had neurological abnormalities to which a definite diagnosis could not be given.

Age Factors↗