Recognition of Dementia in General Practice: Comparison of General Practitioners' Opinions with Assessments Using the Mini-Mental State Examination and the Blessed Dementia Rating Scale

Mant A, Eyland E A, Pond D C, Saunders N A and Chancellor AH B. Recognition of dementia in general practice: comparisonof general practitioners' opinions with assessments using themini-mental state examination and the Blessed dementia ratingscale. Family Practice 1988; 5: 184–188. In a study of 226 elderly residents in a retirement villagein Sydney, Australia, general practitioners' opinions aboutdementia status had high positive and negative predictive valuesand high specificity, but low sensitivity when evaluated againstthe mini-mental state examination and the Blessed dementia ratingscale. General practitioners were found to disagree with thesetwo measures more often when patients were in advanced old age,and when they considered the patients to be depressed. We concludethat the general practitioner can increase his or her sensitivityto dementia in the elderly by use of either measure.     

Defensive hostility and anger expression: Relationship to additional heart rate reactivity during active coping

The main purpose of the present study was twofold: (a) to assess the relationship between defensive hostility (high hostility/high defensiveness) and additional heart rate reactivity during active coping and (b) to determine if the construct of anger-out might lend additional, sensitivity to the predictive power of the defensive hostility model. Forty individuals were randomly assigned to complete a mental arithmetic task with or without the threat of shock. Participants also completed the Cook-Medley Hostility Inventory (Ho), the Marlowe-Crowne Social Desirability Scale (MC), and the Spielberger Anger Expression Scale. Defensive hostile subjects (high Ho/high MC) were significantly more reactive than any other subgroup. In addition, the combination of low Ho/high anger-out scores yielded a subgroup significantly less reactive than any other subgroup. These findings clarify the complex relationship of hostility and cardiovascular reactivity.     

Distribution of matrix metalloproteinases and their inhibitor, TIMP-1, in developing human osteophytic bone

Connective tissues synthesise and secrete a family of matrix metalloproteinases (MMPs) which are capable of degrading most components of the extracellular matrix. Animal studies suggest that the MMPs play a role in bone turnover. Using specific polyclonal antisera, immunohistochemistry was used to determine the patterns of synthesis and distribution of collagenase (MMP-1), stromelysin (MMP-3), gelatinase A (MMP-2) and gelatinase B (MMP-9) and of the tissue inhibitor of metalloproteinases-1 (TIMP-1) within developing human osteophytic bone. The different MMPs and TIMP showed distinct patterns of localisation. Collagenase expression was seen at sites of vascular invasion, in osteoblasts synthesising new matrix and in some osteoclasts at sites of resorption. Chondrocytes demonstrated variable levels of collagenase and stromelysin expression throughout the proliferative and hypertrophic regions, stromelysin showing both cell-associated and strong matrix staining. Intense gelatinase B expression was observed at sites of bone resorption in osteoclasts and mononuclear cells. Gelatinase A was only weakly expressed in the fibrocartilage adjacent to areas of endochondral ossification. There was widespread but variable expression of TIMP-1 throughout the fibrous tissue, cartilage and bone. These results indicate that MMPs play a role in the development of human bone from cartilage and fibrous tissue and are likely to have multiple functions.     

Tumors of the Bladder, Kidney, and Intestine of F344 Rats and Liver of B6C3F1 Mice Administered o-Nitroanisole in Feed

Tumors of the Bladder, Kidney, and Intestine of F344 Rats andLiver of B6C3F₁ Mice Administered o-Nitroanisole in Feed. IRWIN,R. D., CHHABRA, R., EUSTIS, S., PINTER, A., AND PREJEAN, J.D. 1996). Fundam. Appl. Toxicol. 30, 1–12. o-Nitroanisole, a mutagenic intermediate used in the manufactureof azo dyes, was administered in feed for 2 years at concentrationsof 0, 222, 666, or 2000 ppm to groups of 60 male and 60 femaleF344 rats. No significant increase in neoplasms occurred inthese groups of rats. Additional (stop exposure) groups of 60male and 60 female F344 rats received diets containing 0, 6000,or 18,000 ppm for 27 weeks followed by maintenance on controldiets for up to an additional 77 weeks. Survival of the stopexposure groups was reduced because of the development of chemicalrelated neoplasms of the urinary bladder. After 13, 28, 40,and 65 weeks on study, 10 rats per group were necropsied andevaluated for the presence of chemical associated lesions. Hyperplasiaof the epithelium of the urinary bladder was significantly increasedat all interim evaluations. A transitional cell carcinoma wasobserved at the 13-week evaluation in one male rat that received18,000 ppm and thereafter transitional cell neoplasms of thebladder were present in male and female rats at each interimevaluation. Adeno matous polyps of the large intestine weresignificantly increased in groups that received 6000 or 18,000ppm. In addition carcino mas of the large intestine were presentin four males and two females that received 18,000 ppm. Hyperplasiaof the transitional epithelium of the renal pelvis was significantlyincreased in groups of rats that received 6000 or 18,000 ppmand transitional cell papillomas were observed in three malesand one female that received 18,000 ppm. Transitional cell carcinomasof the kidney occurred in one male that received 6000 ppm andsix males and one female that received 18,000. Groups of 60male and 60 female B6C3F₁, mice received dietary concentrationsof 0, 666, 2000, or 6000 ppm o-nitroanisole for 2 years. Nostop exposure study was conducted with mice. The only neoplasticresponse observed in mice was in the liver of males; hepatocellularadenomas or carcino mas were increased in groups of male micethat received 2000 or 6000 ppm. No increase in neoplasms associatedwith chemical exposure occurred in female mice.     

Retinoid-Induced Hypertriglyceridemia in Rats Is Mediated by Retinoic Acid Receptors

Retinoids in clinical use today are known to induce hypertriglyceridemiaas one of their major side effects. The purpose of the presentstudy was to determine, in an appropriate animal model, if retinoid-inducedhypertriglyceridemia is mediated by retinoic acid receptors(RARs) and/or by retinoid X receptors (RXRs). Oral gavage ofmale Fischer rats with 13-cis-retinoic acid for 6 days causeda rapid and sustained increase in serum triglycerides that wasreversible within 4 days posttreatment In subsequent experiments,rats were treated by gavage once daily for 3 days with variousretinoids, and serum triglyceride levels were determined 24hr after the last treatment without fasting. All-trans-and 13-cis-retinoicacid, which can be converted to both RAR and RXR agonists, and9-cis-retinoic acid, an RAR/RXR pan-agonist, caused dose-dependentincreases in serum triglycerides at doses that did not causeweight loss or mucocutaneous toxicity. Ro 13–6298 andAGN 190121, two RAR-specific agonists, caused dose-dependentincreases in serum triglycerides, although Ro 13–6298only induced hypertriglyceridemia at weight-suppressive doses.Two RXR-selective agonists, LG100268 and AGN 191701, failedto induce hypertriglyceridemia or weight loss up to the highestdoses tested. A structural isomer of AGN 190121 that does notactivate RARs or RXRs, AGN 190727, did not induce hypertriglyceridemia.Hypertriglyceridemia induced by AGN 190121 was significantlyinhibited by co-treatment with an RAR-selective antagonist,AGN 193109. Taken together, these data provide strong evidencethat retinoid-induced hypertriglyceridemia is mediated, at leastin part, by RARs. These data also suggest that RXR-specificagonists may have reduced potential to induce hypertriglyceridemiarelative to RAR-active retinoids.     

Reproductive Study of Acrolein on Two Generations of Rats

Four groups of 30 male and 30 female rats were intubated with70 daily doses of acrolein at levels of 0, 1, 3, or 6 mg/kgin a dosing volume of 5 ml/kg. Rats within each dosing group(F₀ generation) were then assigned to a 21-day period of cohabitationand dosing for females continued through cohabitation gestationand lactation. Males were euthanized after cohabitation. F₁generation rats were chosen from pups, and a similar pretreatment,cohabitation, gestation, and lactation regimen was accomplishedresulting in F₂ generation pups. Reproductive parameters, bodyweights, food consumption, and clinical signs were recordedand necropsies were carried out on all treated animals. Histopathologicexams were accomplished on selected reproductive tissues. Inaddition, gross lesions, target tissues, stomachs, and lungswere examined. For the most part, reproductive parameters wereunaffected by acrolein treatment with the exception of reducedpup weights in the F₁ generation pups at the high-dose level(6 mg/kg/day). Gastric lesions were noted consistently in high-doseanimals and some mid-dose (3 mg/kg/day) rats. Erosions of glandularmucosa and hyperplasia/hyper keratosis of the forestomach werethe most frequent stomach lesions observed. Effects on bodyweight gains were noted frequently for the high-dose animalsand achieved statistical sig nificance in the mid-dose animalson several occasions. Mortality in all high-dose animals waselevated relative to control animals. Acrolein, therefore, cannotbe considered a selective reproductive toxin in the rat, butdoes produce toxicological effects down to a dosing level of3 mg/kg/day.