Emotion processing in Alzheimer's disease

To date, there have been few studies of emotion processing in those suffering from Alzheimer's disease, yet this may have an important effect on the quality of life of both sufferers and their families. This paper describes an investigation of the relative changes in cognition and in recognition and identification of non-verbal communicative signals of emotion in those suffering from Alzheimer's disease, and seeks to address the implications for clinical practice. Twelve adults with a diagnosis of "probable" Alzheimer's disease and 12 matched older adult healthy comparison participants undertook a series of tasks involving face and prosody discrimination. Facial stimuli were presented on cards, and prosodic stimuli on audiotape. Scores were compared with a measure of general cognitive ability. There was a significant difference between the Alzheimer's disease group and healthy older adult group on emotion and cognition tasks respectively. However, the ability to recognize and identify non-verbal affect cues in emotional facial expression and emotional prosody was preserved relative to general cognitive ability in those suffering from Alzheimer's disease. In addition, there were no differences found in the recognition of different emotions (happiness, sadness, anger, fear or neutral). This relative sparing of non-verbal emotional processing skills has implications for provision of assessment and interventions based on the creation of effective forms of communication that are less reliant on cognitive ability.     

Patterns of clinically detectable treatment effects with galantamine: a qualitative analysis

The Clinician's Interview Based Impression of Change, plus carer interview (CIBIC-Plus) is widely used in anti-dementia drug trials. It includes clinicians' notes about patients' behaviour, function, and cognition, and a 7-point clinical global impression of change scale that summarizes patients' changes during treatment. We analyzed the narrative content of clinicians' notes from a randomized, controlled trial of galantamine, an anti-Alzheimer's disease drug, and identified varying degrees of improvement and decline. In general, while most patients were rated as showing 'no change', considerable changes were seen in such patients, but were judged by clinicians to have been offset by decline in other areas. Most patients rated as 'improved' showed combinations of cognitive, functional and/or behavioural improvement or stability. While patients with signs of cognitive improvement could be found across the scale from 'very much improved' to 'minimally worse', patients with functional improvement were rated as having improved or not having changed. Cognitive declines in several domains or any cognitive decline seen with functional declines were the chief drivers of worsening ratings. The CIBIC-Plus notes have potential value in identifying reproducible patterns of clinically relevant treatment effects provided that data are consistent and specific, and that seemingly contradictory information is carefully explored. Clinicians appear to be skeptical of cognitive changes not supported by like changes in function or behaviour.     

Skin absorption from patch test systems

The development of topical drug products requires testing for skin toxicology reactions. A variety of patch test systems are available with which chemicals are applied to skin. The purpose of this study was to determine the skin absorption of paraphenylenediamine (PPDA) from a variety of such systems. [14C]-PPDA (1% pet., USP) was placed in a variety of patch test systems at a concentration normalized to equal surface area (2 mg/mm2). Skin absorption was determined in the guinea pig by urinary excretion of 14C. There was a six-fold difference in the range of skin absorption (p less than 0.02). In decreasing order, % skin absorption from the systems were Hill Top Chamber (53.4 +/- 20.6) greater than Teflon Control patch (48.6 +/- 9.3) greater than Small Finn Chamber with paper disc insert (34.1 +/- 19.8) greater than Small Finn Chamber (29.8 +/- 9.0) greater than Large Finn Chamber (23.1 +/- 7.3) greater than AL-Test Chamber (8.0 +/- 0.8). Thus, the choice of patch system could produce a false negative error if the system inhibits skin absorption, with a subsequent skin toxicology reaction.     

Does a neuropsychological index of hemispheric lateralization predict onset of upper respiratory tract infectious symptoms?

Objectives. Past studies demonstrate relationships between hemispheric lateralization (HL) and immunity. However, the relevance of HL–immune relationships to health and illness has rarely been investigated. This study tested whether a neuropsychological index of right‐hemispheric lateralization (right‐HL) predicts development of upper respiratory tract infectious (URTI) symptoms. Design. We used a prospective, matched, case‐control design. Methods. Initially, 80 URTI symptom free adults underwent neuropsychological assessment including right‐HL (picture vs. word recognition), and were then followed‐up during 10 weeks for development of URTI symptoms and objective signs of URTI. Participants reporting URTI symptoms (Ill; N =21) were matched on age, gender, and IQ with 21 participants remaining well. Results. At baseline, the right‐HL index was significantly higher in participants who later became ill (9.9%) compared to well participants (3.9%, p <.05). Health behaviour also predicted URTI symptoms. In a logistic regression, right‐HL significantly predicted self‐reported URTI, independent of health behaviour and neuroticism. Conclusions. Greater right‐HL predicted URTI symptom development during follow‐up, independent of important confounders. These findings expand previous HL–immune relationships to a common immune‐related illness.     

In vivo percutaneous absorption of chemicals: a multiple dose study in rhesus monkeys

The effect of daily topical application on the in vivo percutaneous absorption of benzoic acid, parathion and salicylic acid in rhesus monkeys has been investigated. The study was designed to test further the hypothesis that topical bioavailability, or body burden, of a chemical following chronic exposure may be accurately predicted from the result of a single acute-dose experiment. No significant change in percutaneous absorption from that following the initial dose was observed following the eighth daily dose of a 14-day multidose regimen for each of the three penetrants considered. The results are consistent with those of recent experiments in humans with malathion and steroids, but not entirely consistent with the results of other animal studies.     

Differences in the attitudes of men and women practitioners to responsibility and competence.

A study has been carried out to predict the prescribing and referral behaviour of general practitioners by measuring their attitudes to their roles. Part of this study involved determining whether women doctors accept greater responsibility and feel more competent than men when undertaking those tasks for which they are said to be suited. In May 1987 a postal questionnaire was sent to all 525 general practitioners in contract with Avon family practitioner committee. Replies from 82 women and 289 men showed that women accepted more responsibility for sex-related tasks. For other medical tasks, including those of a technical and traditional nature, men accepted both more responsibility and felt more competent than did women respondents. Contrary to expectations, women did not accept more responsibility or feel more competent than men for psychosocial tasks. The results are discussed in the context of the role of women within medicine.     

Towards a typology of general practitioners' attitudes to general practice

Current knowledge about the origins of variations in general practitioners' (GPs') prescribing and referral behaviour is limited. Differences are as yet unexplained by demographic factors such as list size or geographic location. Drawing on social psychological theory it is suggested that attitudes towards general practice held by GPs may be predictive of GP behaviour. A classification of GP types on the basis of expressed attitudes may represent the first step towards this goal. This research demonstrates that GPs in Avon have identifiable attitudes to general practice which can be classified into separate types. Uses of such a classification and implications for further research are also discussed.     

可疑痴呆人群中阿尔茨海默氏病临床前的认识损害特征及其与中医证候的关系

1背景可疑痴呆（Questionabledementia,QD）概念被用来描述那些有认知障碍而又不符合痴呆诊断标准的患者群,由美国老年病学家D．P．Devand博士等于1996年在第45期《美国老年病学杂志》首次提出[1]。有关健康与衰老的大量研究显示,65岁以上人群中约30％的人有认知障碍但尚未达到痴呆诊断标准[2]。平均2．5年随访研究发现,41．3％的QD个体进展为痴呆,44％的QD不能确定是痴呆,14．7％的人仍是QD[1]。Bowen等[3]报告QD转化成痴呆的数量随着随访时间的延长而增加,在18、36、54个月后随访时转化率分别为24％、44％和55％。有证据表明…