Search PubMed⌕ Search

Biomedical subjects

J H Fox

Publications and source records attributed to J H Fox.

At least 37 records · Page 2Linked to original sources
PubMed1991

Predictors of behavioral disturbance in Alzheimer's disease.

The relationship of behavioral disturbances in Alzheimer's disease to disease severity, age at onset, and the presence of extrapyramidal signs was investigated in three studies. Five categories of behavior disturbance were ascertained through structured interview with the patient's primary caregiver: apathy, agitation, psychotic symptoms, disinhibition, and irritability. In Study 1, measures of disease severity accounted for 42% of the variance in the Apathy scale but less than 20% of the variance in the remaining scales. In Study 2, the presence of extrapyramidal signs was associated with increased Apathy and moderated the association between disease severity and the Psychotic Symptoms and Irritability scales. In Study 3, age at onset was associated with the Agitation scale and moderated the association between disease severity and the Apathy, Psychotic Symptoms, and Irritability scales. The findings are discussed in terms of the clinical heterogeneity within Alzheimer's disease, the possible biological bases of these behavioral disturbances, and the psychometric issues pertinent to their measurement.

Age Factors↗
PubMed1991

The concept of uterine preservation with ovarian malignancies.

A 30-year-old woman with bilateral, recurrent, borderline papillary serous cystadenocarcinoma of the ovary was treated with bilateral oophorocystectomy and omentectomy with uterine preservation. Ten years later, through induction of an artificial endometrial cycle and ovum donation, she conceived twins and delivered two healthy infants. Staging exploratory laparotomy at the time of cesarean delivery was negative for malignancy. This case illustrates the value of uterine preservation for cases in which classical teaching has indicated hysterectomy with bilateral salpingoophorectomy.

Adult↗
PubMed1991

Cessation of driving and unsafe motor vehicle operation by dementia patients.

We surveyed 522 consecutive patients from a dementia clinic to assess duration of driving after disease onset and instances of unsafe motor vehicle operation in the preceding 6 months. Among the 333 patients licensed to drive at the onset of dementia, the median duration of driving after onset was 28.6 months. Patients with a clinical diagnosis of Alzheimer's disease drove significantly longer than those with other dementia syndromes. Of the 93 patients still driving at the time of the survey, approximately one third were reported to have had at least one form of unsafe motor vehicle operation in the past 6 months, including 21 patients with motor vehicle accidents. Motor vehicle accidents were associated with use of prescription medications with sedative properties and with lower subjective ratings of the patient's driving ability by the informant.

Accidents, Traffic↗
PubMed1990

Sexual selection for sensory exploitation in the frog Physalaemus pustulosus.

The sensory bases of species and population mate preferences are well known; in frogs properties of the female auditory system influence such preferences. By contrast, there is little understanding of how sensory characteristics could result in sexual selection within a population. One possible mechanism is that females are more sensitive to male courtship signals that deviate from the population mean. We document this mechanism in the frog Physalaemus pustulosus. Female basilar papilla tuning is biased toward lower-than-average frequencies in the 'chuck' portion of the male's call, explaining female preference for the lower-frequency chucks produced by larger males. The tuning does not differ between P. pustulosus and its close relative P. coloradorum, a species in which males never evolved the ability to produce chucks; thus the female tuning evolved before the chuck and therefore the chuck played no role in the evolution of the preference. This allows us to reject two popular hypotheses for the evolution of this female preference (runaway sexual selection and natural selection) in favour of a third: sexual selection for sensory exploitation.

Animals↗
PubMed1990

Preserved word-stem-completion priming of semantically encoded information in Alzheimer's disease.

Alzheimer's disease (AD) patients and normal elderly control subjects completed 80 standardized sentence frames with single words, yielding a measure of semantic memory. Memory for best fit sentence endings was then tested either explicitly, with a forced-choice recognition task, or implicitly, with a word-stem-completion task. The patients completed fewer sentences with best fit word endings than did the control subjects. Explicit retention was markedly defective in the AD group, but word-stem completion was normal. The preserved word-stem completion in AD is discussed in terms of encoding operations and transfer-appropriate processing.

Aged↗
PubMed1990

Clinical diagnosis of Binswanger's disease.

To aid in the prospective study of Binswanger's disease, a poorly understood form of vascular dementia, a standardised criteria for its antemortem diagnosis was proposed. These criteria include dementia, bilateral radiological abnormalities on computed tomography (CT) or magnetic resonance imaging (MRI), and at least two of the following three clinical findings: A) a vascular risk factor or evidence of systemic vascular disease; B) evidence of focal cerebrovascular disease; and C) evidence of "subcortical" cerebral dysfunction. These criteria were validated in two ways. First, by retrospectively applying them to a series of 30 demented patients with various pathological diagnoses. Second, by prospectively applying them to a series of 184 patients with clinically typical Alzheimer's disease. The sensitivity and specificity of the criteria appear adequate for use in clinical research.

Alzheimer Disease↗
PubMed1988

Intraventricular bethanechol infusion for Alzheimer's disease: results of double-blind and escalating-dose trials.

Ten patients with biopsy-proven Alzheimer's disease (AD) received low-dose (0.35 mg/d) intraventricular bethanechol, a muscarinic agonist, and saline placebo in a 24-week double-blind crossover design. Eight of these ten patients later participated in an open escalating-dose (to 1.75 mg/d) trial of bethanechol. Patients' drug responses were assessed by neuropsychological examination and informant measures of activities of daily living, mood disturbance, and abnormal behavior. Bethanechol appears to have a narrow therapeutic window for positive effects; low doses did not reliably alter patient functioning, moderately increased doses appeared to have a palliative effect on patient mood and behavior, and the highest dose was detrimental to patient functioning. Bethanechol does not appear to ameliorate the dementia of AD, but may exert a mildly positive effect on patient behavior and mood.

Aged↗
PubMed1987

Cortical biopsy results in Alzheimer's disease: correlation with cognitive deficits.

Neuropsychologic and pathologic data are presented for a group of 11 patients with a clinical diagnosis of probable Alzheimer's disease (AD) according to recently proposed criteria. In all cases, the diagnosis was verified by cortical biopsy. In addition, increased cortical plaque counts were associated with greater deficits in language production and comprehension and poorer performance on an index of global mental status. These results suggest that a clinical diagnosis of AD is very accurate when patient selection is restricted to typical cases and that language deficits may provide a useful indicator of severity of disease in AD patients.

Aged↗
PubMed1986

Cognitive assessment in Alzheimer's disease: cross-sectional and longitudinal perspectives.

This paper describes select results of a longitudinal study of 62 mild to moderate Alzheimer's disease (AD) patients, in comparison to 60 age-matched healthy controls. Initial neurologic, radiologic, psychiatric, laboratory and cognitive examinations, required two full days, followed by one-day examinations at annual intervals. Of the total original sample, 31 AD patients and 39 controls could actually be followed for three annual examinations. Cognitive examination data confirmed cross-sectional (group discriminative) validity of memory and language measures, and showed the expected longitudinal deterioration in the AD sample, with controls maintaining consistent performance over the three years. However, those measures showing largest group differences at initial examination were not the best for tracking patient deterioration over time. Implications of these results for the selection of cognitive assessment measures are discussed.

Alzheimer Disease↗
PubMed1986

Allometry of major CNS divisions: towards a reevaluation of somatic brain-body scaling.

For each of four rodent species, average weights for the brainstem, cerebellum, and forebrain were determined and average cross-sectional area of the cervical spinal cord (SCA) was calculated. Linear regression analyses against log body weight were performed on these data (log translated), along with data (except SCA) from the literature for insectivores and primates. Results indicate that the different CNS divisions scale by different powers of body weight in different mammals and that the rodent SCA varies by less than the 2/3 power of body weight. Based on the results, we conclude that there are at least two general brain scaling factors, somatic and nonsomatic, that necessitate a more complex general allometric equation; the exponent for somatic brain scaling is approximately 0.52, and body surface area is not a primary determinant of brain size.

Animals↗
PubMed1985

Senile gait. A distinct neurologic entity.

Neurologic disease may result in a variety of different gait abnormalities. Senile gait is a distinct neurologic disorder and signs of dysfunction of major neuroanatomic systems are absent. The clinical picture is variable. Senile gait is not directly associated with dementing illness and its anatomic basis is unknown. It does not appear related to hydrocephalus. It is a specific clinical entity related to the degeneration of the nervous system. Further studies are needed to better understand this condition and to develop therapeutic approaches.

Accidents↗
PubMed1983

Word frequency effect and recognition memory in dementia of the Alzheimer type.

Normal persons show better recognition memory for rare than for common words. In the first experiment, we examined this word frequency effect in 17 patients with dementia of the Alzheimer type (DAT) and 20 normal controls of equivalent age and education. The DAT patients showed a normal tendency to false alarm to common words but failed to show the normal rare word advantage in their hit rate. In a second experiment, we examined normal memory immediately and after a delay of 1 week when it is approximately equivalent to that of DAT patients. There was no attenuation of the usual rare word advantage. These findings suggest that DAT patients fail to encode the featural and intrastructural elements of to-be-remembered verbal information and that this processing deficit may contribute to their impaired recognition memory performance.

Adult↗