In Germany, the general practitioner plays an important role in the allocation process of rehabilitative measures. A survey concerning the questions of need, demand and effectiveness of medical rehabilitation measures as seen from the general practitioner's perspective in Hamburg, Schleswig-Holstein und Halle/Saale (n = 956) in 1999 shows that general practitioners have a rather positive attitude towards rehabilitation in general. With regard to the different measures within the rehabilitation system they show a differentiated opinion. As they see a large percentage of over- and underuse of rehabilitation they would appreciate that their information on the patient would be more intensively taken into account in the allocation process. 相似文献
Electrical stimulation of the cerebellar fastigial nucleus (FN) elevates regional cerebral blood flow (rCBF) independently of cerebral metabolism (rCGU) throughout brain. One hour of FN stimulation also reduces, by up to 50%, the volume of the focal ischemic infarction produced by occlusion of the middle cerebral artery in rat. Protected areas correspond to the ischemic penumbra. Neuroprotection, while reversible, persists for weeks after 1h of stimulation. It cannot be attributed to increasing rCBF and/or reducing rCGU to improve matching of flow and metabolism. Conditional stimulation of FN initiates long-lived inhibition of expression of peri-infarction depolarizing waves, possibly by altering potassium-channel function and suppresses induction of inducible nitric oxide synthase (iNOS) and ICAM in cerebral microvessels. The brain contains intrinsic networks which may protect the brain from ischemic injury, possibly by producing widespread and longterm suppression of electrical excitability and/or and expression of proinflammatory molecules. 相似文献
An increasing number of longitudinal cohort studies have identified a risk increase for dementia by the chronic use of drugs with anticholinergic properties. The respective data from the German Study on Aging, Cognition and Dementia in Primary Care Patients (AgeCoDe) also showing risk increase (hazard ratio = 2.081) are reported here. The mechanisms by which the risk increase is transported are still unknown. Irritation of compensated alterations of cholinergic transmission at the pre-dementia stage of Alzheimer’s disease (AD) or acceleration of neuroinflammation by disturbance of the anti-inflammatory effect of cholinergic innervation are discussed. In terms of dementia prevention, centrally acting anticholinergic drugs should be strictly avoided, because of long-term dementia risk increase in addition to acute negative effects on cognition.
Cognitive functions show large variation in elderly people and are substantially heritable. Animal studies revealed that dynorphins influence cognition and memory, especially in aged animals. Thus, we tested the effect of four SNPs (rs7272891, rs1997794, rs2235751 and rs910080) and the VNTR promoter polymorphism in the prodynorphin gene (PDYN) on episodic memory and verbal fluency in a large (n = 1619) sample of elderly people (mean age: 80 ± 3.39 years; range 75–90 years) recruited through the German study on ageing, cognition and dementia in primary care patients (AgeCoDe). We found that carriers of the minor alleles of rs1997794 (P < 0.002) and rs910080 (P < 0.005) presented with higher episodic memory scores than homozygote carriers of the major allele. Also, a three marker haplotype including these two SNPs and rs2235751 was associated with better episodic memory scores. Verbal fluency scores were non-significantly better in carriers of these respective alleles. Thus, our results suggest a role of PDYN gene variations in determining memory function also in elderly humans. 相似文献
The genes encoding effector molecules of mature T cells, IL-2, perforin and
IL-4, were found to be expressed in vivo in the most primitive subsets of
thymocytes of adult mice. These subsets have previously been identified by
their cell surface markers and by their expression of other T
lineage-associated genes. While IL-2, perforin and IL-4 are expressed in
distinct patterns, all three are expressed before the induction of RAG-1
and pre-TCR alpha mRNA expression, and are confined to subsets of cells
that apparently have not yet undergone commitment to the T lineage. Thus,
expression of T cell response genes appears to be one of the earliest
markers of lymphocyte differentiation. Activation events marked by CD69
induction occur in these early cell types, but the response gene expression
by these cells is separable from CD69 expression. IL-2 and perforin are
induced again much later in thymocyte development, during TCR-dependent
repertoire selection. At those stages, IL-2 protein and RNA levels per cell
are higher, but the fraction of cells expressing IL-2 appears to be much
lower than in the most immature stages. In addition, a striking feature of
the immature populations is the robust IL-2 expression by presumptive
immature NK cells. These findings are discussed in terms of the
developmental origins of lineage specificity in T cell response gene
regulation.
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Three cases of papillary carcinoma of the prostate (also called endometrial adenocarcinoma of the prostate; endometrioid carcinoma) were studied for prostate-specific antigen in order to determine their origin and histogenesis. All 3 cases were prostate-specific antigen positive. Two patients were treated with hormonal therapy, 1 with radiotherapy. 相似文献
This report describes double-blind placebo-controlled trials of a new synthetic antirhinovirus drug, R61837, which showed it to be effective in suppressing colds in human volunteers challenged with rhinovirus type 9. In one trial, R61837 was given by intranasal spray six times a day, commencing 28 h before virus challenge; treatment continued for 4 days and one dose (total dose, 25 mg). This regimen suppressed symptoms until 48 h after medication ceased, at which time colds developed. In another trial, medication with R61837 commenced at 4 h before virus challenge and continued for a total of 6 days (total dose, 36 mg). The drug produced substantial reductions in both the mean daily clinical score and the mean daily nasal secretion weight compared with patients given the placebo. These differences reached statistical significance for 2 and 4 days, respectively. In a further trial, intranasal R61837 was not effective in treating colds even when given shortly after the onset of symptoms and in doses of up to 15 mg/day. 相似文献