Mycobacterium intracellulare soft tissue infection.
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
R Jacoby
Publications and source records attributed to R Jacoby.
Psychiatric morbidity in bus crews following violent assault: a follow-up study.
In a prospective study 22 bus crews who were victims of physical assault were assessed using standardized psychiatric instruments, followed up for 18 months and compared to a non-assaulted control group drawn from the same bus garage. At initial assessment the assaulted group, compared to the controls showed a significant increase in psychiatric impairment and distress (as measured by the GHQ-30 and IES respectively), with 23% of assault victims developing post-traumatic stress disorder as defined by DSM-III-R. At follow-up, while high levels of both psychiatric impairment and distress persisted there was evidence that they may be separate phenomena.
Adult↗
Computed tomography in Alzheimer's disease: a longitudinal study.
Sixty-three patients satisfying NINCDS/ADRDA criteria for Alzheimer's disease (AD) received neuropsychological tests and computed tomography (CT) scans 12 months apart. Significant deterioration occurred in all the cognitive tests and in the CT measures used, that is, lateral ventricular size, third ventricular size, and cortical atrophy. There was a wide variation in the size of the changes taking place; 14 of 63 patients showed no significant change and 6 showed a marked increase in ventricular size. However, neither group differed from the others in any demographic, cognitive, or other CT variables which suggested, on the CT measures used, that no clearly identifiable subgroups of AD were present. Change in CT indices was not related to initial severity of disease. An increase in ventricular size was related to deterioration of cognitive function. These results require further replication. The methodological drawbacks of such studies are discussed.
Aged↗
Evidence for a common molecular pathogenesis in colorectal, gastric, and pancreatic cancer.
We examined tissue extracted from 19 gastric, 7 pancreatic, and 23 colorectal carcinoma specimens to determine the comparative incidence of allele loss on chromosomes 5, 17, and 18 and that of KRAS2 point mutations. Chromosome 5 allele loss occurred at the same frequency in all three gastrointestinal tumors (approximately 30%), whereas chromosome 17 and 18 allele losses were seen at a significantly lower frequency in gastric (20%) and pancreatic (0%) malignancies than in colorectal cancer (57%). Point mutations in KRAS2 were seen in 83% of pancreatic and 52% of colon cancers, but not in gastric cancer specimens. In pancreatic tumors, these mutations were always found in the second nucleotide of codon 12. In colorectal cancer, the distribution was more variable, involving the second nucleotide of codon 13 and both the first and second nucleotides of codon 12. These results suggest that inactivation of the adenomatous polyposis coli gene on chromosome 5 may be an initiating step for carcinomas of the stomach and pancreas as well as of the colon, but that the genes involved in tumor progression events may be tissue- or tumor-specific.
Adenocarcinoma↗
Factors affecting survival in Alzheimer's disease.
Factors affecting survival of 178 patients diagnosed using NINCDS/ADRDA criteria for Alzheimer's disease were studied. All patients were drawn from the Camberwell Health Authority Area and so were a representative sample of subjects from a clinical old age psychiatry service. The mortality rate of the sample was 3.5 times that expected after adjustment for age. Younger subjects had a higher standardized mortality ratio than older subjects. The cumulative three-year mortality of the sample was 47%. Factors shown to be associated with a reduced survival included: increasing age, longer duration of illness, male sex, presence of physical illness, poor cognitive function, observed depression and absence of misidentification syndromes. Apraxia was a stronger predictor of early death than aphasia or dysmnesia.
Aged↗
Neurological signs in Alzheimer's disease.
Neurological signs were assessed in 178 patients satisfying NINCDS/ADRDA criteria for Alzheimer's disease. A snout reflex was present in 41%, extrapyramidal signs in 12%, drug-induced extrapyramidal signs in 3%, myoclonus in 5%, and a history of epileptic fits in 3%. A grasp reflex, extrapyramidal signs and symptoms were associated with severe cognitive impairment. On CT scanning, extrapyramidal signs were associated with increased 3rd ventricular size and basal ganglia calcification, a grasp reflex with frontal lobe atrophy and a history of epilepsy with left temporal lobe atrophy. Lateral ventricular size was greater in patients developing a grasp reflex during a 12 month follow-up. Extrapyramidal signs and primitive reflexes were associated with a higher mortality.
Aged↗
Progression of cognitive impairment in Alzheimer's disease.
Change in cognitive function was assessed over 12 months in 110 patients over the age of 65 satisfying National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS/ADRDA) criteria for "probable" Alzheimer's Disease. A highly significant deterioration in cognitive function was observed. Decline in cognitive scores was relatively normally distributed. Patients who died during the follow-up had more apraxia at entry to the study than survivors. A greater rate of decline was seen in patients whose parents suffered from dementia (but not in those where a sibling or other relative was affected), in subjects who had moderate dementia, and those who had been ill for less than 24 months. Age, age of onset, and the presence or absence of aphasia or apraxia had no influence on rate of progression. A cluster analysis revealed three patterns of decline.
Age Factors↗
Computerised tomography in Alzheimer's disease. Methods of scan analysis, comparison with normal controls, and clinical/radiological associations.
One hundred and thirty-eight patients satisfying NINCDS/ADRDA criteria for Alzheimer's disease (AD) and 36 normal controls underwent cranial CT. A comparison of methods of scan analysis showed good agreement between computer-assisted methods and visual ratings and planimetry. The CT scans of controls differed significantly from patients and a discriminant analysis, based on all CT measures, predicted group membership (control or patient) in 81% of cases. Within the AD group, cortical atrophy correlated with age and duration of illness. Global tests of cognitive function correlated significantly with both cortical atrophy and ventricular size. Subjects who died in a three-year follow-up had more atrophy and larger third ventricles than survivors, but this effect was due entirely to increased age.
Aged↗
Neuroanatomical correlates of clinical misidentification and misperception in senile dementia of the Alzheimer type.
BACKGROUND: Impaired frontal lobe and/or nondominant hemisphere lesions have been described in patients with typical misidentification syndromes (e.g., Capgras' syndrome or reduplicative paramnesia) who had various underlying psychiatric or neurologic disorders. In a prospective long-term study, the authors examined computed tomography measurements of patients with senile dementia of the Alzheimer type (DAT) to determine whether the forms of misidentification they suffered might correlate with organic factors. METHOD: One hundred twenty-eight consecutive DAT patients were examined by means of standardized clinical instruments (Mini-Mental State score, CAMCOG, the Benton facial recognition test, the Kendrick object learning test, CAMDEX, and the Geriatric Mental State Schedule) and computed tomography. RESULTS: Of the 128 patients, 40 showed symptoms of misidentification; 25 of them misidentified other people in their homes, 7 misidentified their own mirror images, and 7 misidentified television images as being real. Computer-assisted planimetric computed tomography measurements showed that patients with misidentification syndromes had significantly larger right anterior horn areas of the lateral ventricle and significantly larger left anterior brain areas than did patients without such symptoms. CONCLUSIONS: The authors conclude that an accentuated degeneration of the right frontal lobe (and a relative preservation of the left frontal lobe) may be associated with delusional misidentification symptoms in DAT.
Aged↗
Accuracy of clinical diagnosis of Alzheimer's disease.
Explore the source record for details and available documents.
Aged↗
Behavioral abnormalities and psychiatric symptoms in Alzheimer's disease: preliminary findings.
Behavioral abnormalities and psychiatric symptoms were assessed in 178 patients diagnosed as having Alzheimer's disease by NINCDS/ADRDA criteria. The subjects were selected from a defined catchment area and therefore were representative of a group of patients with Alzheimer's disease of varying severity. Auditory hallucinations were found in 10%, visual hallucinations in 13%, and delusions in 16%. Symptoms suggestive of depression were reported by 39% of the patients and features of depression observed in 25%. Twenty percent were aggressive, and 7% were sexually disinhibited. Nineteen percent exhibited excessive walking behavior and 10% binge eating. Nearly 50% of the sample were incontinent. Patients in the hospital were more often aggressive, incontinent, and seemingly less depressed. Patients with severe dementia displayed excessive walking behavior, were more likely to be incontinent, and reported less depressive symptoms than those with moderate or mild dementia.
Activities of Daily Living↗
Transcendence and psychological health: studies with long-term participants of the transcendental meditation and TM-Sidhi program.
We investigated the nature of the relationship between experiences of transcendental consciousness and psychological health. In Study 1, three groups with different levels of experience in transcendental meditation (TM) and in the TM-Sidhi program (techniques that have been shown to produce experiences of transcendental consciousness) were studied, using the self-investigation method of Hermans (1976). We employed blind interviewers and raters with various attitudes toward TM to minimize the possible impact of a variety of artifacts. Cross-sectionally, experience with TM and the TM-Sidhi program was positively related to a general measure of psychological health (p = .002); longitudinally, the meditating groups improved more than the control group on the psychological health measure (p less than .03). In Study 2, two contrast groups of long-term participants were similar on several confounding variables but differed on physiological indicators of experiences of transcendental consciousness. The groups with the positive physiological indicators showed a trend toward higher scores on the psychological health factor (p = .092), indicating that psychological health may be developed through the systematic cultivation of transcendental meditation and the TM-Sidhi program.
Adaptation, Psychological↗
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↗
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↗
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↗
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↗
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↗