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131.
RA Lawson AJ Yarnall F Johnston GW Duncan TK Khoo D Collerton JP Taylor DJ Burn On behalf of the ICICLE‐PD study group 《International journal of geriatric psychiatry》2017,32(12):1362-1370
Background
The quality of life (QoL) of informal caregivers of people with Parkinson's disease (PD) (PwP) can be affected by the caring role. Because of cognitive symptoms and diminished activities of daily living, in addition to the management of motor symptoms, carers of PwP and cognitive impairment may experience increased levels of burden and poorer QoL compared with carers of PwP without cognitive impairment. This study aimed to investigate the impact of cognitive impairment in PD upon QoL of carers.Methods
Approximately 36 months after diagnosis, 66 dyadic couples of PwP and carers completed assessments. PwP completed a schedule of neuropsychological assessments and QoL measures; carers of PwP completed demographic questionnaires and assessments of QoL. Factor scores of attention, memory/executive function and global cognition, as derived by principal component analysis, were used to evaluate cognitive domains.Results
Hierarchical regression analysis found lower Montreal Cognitive Assessment was a significant independent predictor of poorer carer QoL, in addition to number of hours spent caregiving, carer depression and PD motor severity. Attentional deficits accounted for the largest proportion of variance of carer QoL. Carers of PwP and dementia (n = 9) had significantly poorer QoL scores compared with PwP and mild cognitive impairment (n = 18) or normal cognition (n = 39) carers (p < 0.01).Conclusions
Attentional deficits were the strongest predictor of carer QoL compared with other cognitive predictors. Carers for those with PD dementia reported the poorest QoL. Interventions such as respite or cognitive behavioural therapy to improve mood and self‐efficacy in carers may improve carer QoL. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. 相似文献132.
M J Harris D Panton M P Caligiuri A J Krull T K Tran-Johnson D V Jeste 《Psychopharmacology bulletin》1992,28(1):87-92
We are conducting a prospective study of tardive dyskinesia (TD) in psychiatric patients over age 45, a large proportion of whom have had less than 1 month of total lifetime neuroleptic exposure. Patients are treated with the lowest effective dose of either haloperidol (usually 1-3 mg daily) or thioridazine (usually 25-75 mg daily). Patients are reexamined 1 month and 3 months after initial assessment and then at 3-month intervals. To date, a total of 68 patients (mean age 69.5 years) have been evaluated. Survival analysis showed a 27 percent cumulative incidence of TD (the 95% confidence interval being 14% to 40%) with 6 months of neuroleptic treatment in the study. The TD and non-TD patients did not differ on demographic and baseline clinical measures. Instrumental assessment showed that a greater proportion of TD patients had subclinical evidence of dyskinesia prior to the institution of neuroleptics, compared with non-TD patients. 相似文献
133.
van der Put NM; Thomas CM; Eskes TK; Trijbels FJ; Steegers-Theunissen RP; Mariman EC; De Graaf-Hess A; Smeitink JA; Blom HJ 《QJM : monthly journal of the Association of Physicians》1997,90(8):505-510
Folic acid intake reduces the risk of neural tube defects (NTDs). Although
the 677C-->T mutation in the 5,10-methylenetetrahydrofolate reductase
(MTHFR) gene is a risk factor for NTDs, it only partly explains the
elevated homocysteine levels in mothers of children with NTDs. We measured
vitamin B12, folate and homocysteine in patients with spina bifida (SB),
their parents, and in controls, to investigate which other enzymes of
homocysteine metabolism might be defective. Because homozygosity for the
677C-->T mutation causes decreased plasma folate and increased red-cell
folate (RCF) and plasma homocysteine levels, we excluded individuals
homozygous for that mutation. The remaining SB patients and their parents
still had lowered plasma folate and elevated total homocysteine levels, and
a small subset had decreased vitamin B12 levels. Red-cell folate was the
same in all groups, suggesting that dietary folate intake and its uptake
was normal. Risk of SB was increased at the 25th percentile of plasma
folate and at the 75th percentile of homocysteine values in SB patients and
their parents, and at the 5th and 25th percentiles of vitamin B12 in
mothers with SB- affected offspring. This underlines the functional
importance of homocysteine remethylation to methionine. There was no
correlation between vitamin B12 and homocysteine or RCF. In combination
with the lowered plasma folate (80-90% 5-methyltetrahydrofolate), our data
do not support a major involvement of methionine synthase in the aetiology
of SB. Our data rather favour the involvement of genetic variation at loci
coding for the formation of 5-methyltetrahydrofolate, such as MTHFR,
methylenetetrahydrofolate dehydrogenase or serine hydroxymethyltransferase.
相似文献
134.
135.
Ketamine hydrochloride 2 mg/kg, together with atropine 0.2 mg, has been given intravenously on 100 occasions on a general paediatric ward. No serious side effects occurred. Dreams followed in 4 children but did not reduce acceptability of the drug. In our hands it has greatly reduced the pain and distress of children undergoing many routine medical procedures, particularly the dread which builds up when these have to be repeated in the same child. It has also produced close to ideal conditions for the operator, and probably increased his efficiency by reducing the emotional strain which occurs when doing painful things to a frightened patient. 相似文献
136.
Houle S; Yip TK; Shepherd FA; Rotstein LE; Sniderman KW; Theis E; Cawthorn RH; Richmond-Cox K 《Radiology》1989,172(3):857-860
The potential use of yttrium-90 glass microspheres in the treatment of hepatocellular carcinoma was assessed in a pilot study of seven patients. The Y-90 microspheres were injected via a hepatic artery catheter. In this group of patients, no toxicity was observed for absorbed doses of between 5,000 and 10,000 cGy to the liver and up to 32,000 cGy to the tumor itself. Tumor response was seen only at the higher absorbed doses. The new Y-90 glass microspheres can safely deliver large doses of internal radiation to hepatic tumors as long as extrahepatic shunting can be excluded. Extrahepatic shunting will be the main limitation to this form of radiation therapy. 相似文献
137.
Monika Kapoor Preeti Singh TK Nayana Siddharth Madan Sarita Beri 《Indian journal of ophthalmology》2020,68(11):2580
An 80-year-old lady with uncontrolled type 2 diabetes developed fever and abdominal pain followed by a sudden diminution of vision in her left eye. Right infra-renal abscess accounted for abdominal pain. A metastatic left subretinal abscess was diagnosed subsequently. Medical management for her systemic condition initiated. Vitreous biopsy was performed along-with intravitreal antibiotic administration. Because of no clinical recovery, patient underwent pars plana vitrectomy. Prompt systemic stabilization and a timely surgical intervention in the left eye resulted in a satisfactory visual gain. Metastatic subretinal abscess following a perinephric abscess is rare phenomenon and only a few cases are reported to date. 相似文献
138.
Ha TK; Sattar N; Talwar D; Cooney J; Simpson K; O'Reilly DS; Lean ME 《QJM : monthly journal of the Association of Physicians》1996,89(10):765-769
Oxidative modification of plasma lipoproteins increases their
atherogenicity. Nutritive antioxidants, including carotenoids, can prevent
such lipoperoxidation and may protect against atherosclerosis. Plasma
retinol, ascorbate, alpha-tocopherol and four carotenoids (lutein,
lycopene, alpha-carotene and beta-carotene) were measured using HPLC in 45
patients with chronic renal failure (CRF) and in 21 controls. Plasma
retinol was significantly increased in patients with CRF (conservative
therapy mean of 3.7 mumol/l vs. 1.9 mumol/l; p < 0.001). Plasma lycopene
was significantly lower in patients with CRF (healthy mean 0.44 mumol/l vs.
conservative therapy mean 0.27 mumol/l and haemodialysis mean of 0.17
mumol/l; p < 0.001), a finding that persisted even after adjusting for
plasma cholesterol. Low circulating antioxidant lycopene levels may
contribute to an already impaired antioxidant defence system in patients
with CRF. The process of haemodialysis further compromises antioxidant
defences, principally by removing water-soluble ascorbate and urate, but
does not appear to affect circulating carotenoid concentrations.
相似文献
139.
140.
P Gruteke MB BCH A Askari MB BS MSc TK Chatterjee MD MRCP MP Chopra MPhil FRCPI FF Nwokolo 《International journal of clinical practice》1992,46(1):63-64
A 33-year-old pregnant atopic woman, who had never suffered from asthma or atopic-related disorder, was admitted on three occasions during her fifth pregnancy with severe asthma. On her last admission she required more intensive monitoring and artificial ventilation. We report this patient and discuss the pathogenesis of asthma during pregnancy. Asthma in pregnancy is not uncommon and it may take a severe course in some pregnancies. In one prospective study 42% of the patients required aggressive management, but none required artificial ventilation. However, there was no difference in the outcome of pregnancies between asthmatic and control subjects.1 Here we describe a patient with severe asthma who required artificial ventilation with a successful outcome. 相似文献