Medication Use in Alzheimer's Disease and Healthy Aging

Abstract

The purpose of this research was to determine if decreased utilization of specific medication in individuals with Alzheimer's disease (AD) reflects a global process of decreased medication usage. Participants were 1103 individuals (461 controls; 437 probable AD; 161 possible AD, and 44 Mixed Dementia), drawn from our Alzheimer's Disease Research Registry. Medication usage at entry into the registry did not differ between controls and probable AD cases. Possible AD and the mixed dementia cases took significantly more medications than controls or probable AD cases. Longitudinal analysis showed no significant changes in controls and mixed dementia cases up to 2 years, and use increased in possible and probable AD cases over time. Stratification of subjects by MMSE scores at entry showed no significant difference between groups. Medication use in probable AD patients does not differ from controls, and does not seem to be subject to systematic bias based on disease progression (as measured by MMSE scores). The presence of co-morbidity adds to medication utilization. Cognitive impairment does not appear to affect total medication use, suggesting that specific medication utilization patterns are unlikely to be the result of larger usage patterns.     

Managing critical incidents in grocery shopping by community-living people with Alzheimer's disease

Abstract

Aim: People with Alzheimer's disease (AD) remain in their ordinary housing and continue to use public space despite increasing disabilities. The aim of this study was to discover and describe problematic situations and critical incidents that took place when people with AD performed the ordinary outside-home activity of grocery shopping and how these were met by them. Methods: Individual interviews (n = 12) and participant observations (n = 8) with six informants were performed and analysed using a grounded theory approach. Results: The findings are presented in six categories and each category describes different critical incidents and actions used to meet these. The categories were: (a) Remembering to bring things when leaving home, (b) Finding the way to and from the grocery shop without getting lost, (c) Finding a way through traffic when not feeling safe, (d) Finding objects when organization is disrupted, (e) Choosing when a lot of objects and products are available, and (f) Finding a method to pay when payment opportunities are restricted. The core category, “A challenging and unstable process of meeting critical incidents in grocery shopping”, was characterised by reflections and creativity to achieve relative harmony in each critical incident. Conclusions: In conclusion, it is important that relatives and professionals take into account relevant actions to help people with AD coordinate with their environment.     

Occupational performance and strategies for managing daily life among the elderly with heart failure

Abstract

Aim: The aim of this study was to describe experiences of limitations in occupational performance and strategies for managing daily activities among the elderly with chronic heart failure (CHF). Methods: Ten participants from primary healthcare with a confirmed diagnosis of CHF were interviewed. The interviews were analysed using qualitative content analysis. Results: The first theme, “Redefining an active life, aware of one’s impaired body”, was based on four sub-themes: realizing one’s limited activity ability; striving to preserve an active life; focusing on meaningful activities; and changing vs. not changing habits and roles. The second theme, “Planning activities and balancing the degree of effort”, was based on three sub-themes: limiting, organizing, and rationalizing activities; adjusting activities to today’s ability; and using technology and adapting the environment. Conclusions: Elderly people with CHF are struggling with an ongoing process of occupational adaptation due to periodical physical decline and fluctuating day-to-day ability. This highlights a need for information on strategies from a holistic perspective and client-centred occupational therapy interventions.     

Induction of cancer cell death by apoptosis and slow release of 5-fluoracil from metal-organic frameworks Cu-BTC

This study aimed to evaluate the mechanism associated with cytotoxic activity displayed by the drug 5-fluorouracil incorporated in Cu-BTC MOF and its slow delivery from the Cu-BTC MOF. Structural characterization encompasses elemental analysis (CHNS), differential scanning calorimetry (DSC), thermogravimetric analysis (TG/DTG), Fournier transform infrared (FIT-IR) and X-ray diffraction (XRD) was performed to verify the process of association between the drug 5-FU and Cu-BTC MOF. Flow cytometry was done to indicate that apoptosis is the mechanism responsible for the cell death. The release profile of the drug 5-FU from Cu-BTC MOF for 48 hours was obeisant. Also, the anti-inflammatory activity was evaluated by the peritonitis testing and the production of nitric oxide and pro-inflammatory cytokines were measured. The chemical characterization of the material indicated the presence of drug associated with the coordination network in a proportion of 0.82 g 5-FU per 1.0 g of Cu-BTC MOF. The cytotoxic tests were carried out against four cell lines: NCI-H292, MCF-7, HT29 and HL60. The Cu-BTC MOF associated drug was extremely cytotoxic against the human breast cancer adenocarcinoma (MCF-7) cell line and against human acute promyelocytic leukemia cells (HL60), cancer cells were killed by apoptosis mechanisms. The drug demonstrated a slow release profile where 82% of the drug was released in 48 hours. The results indicated that the drug incorporated in Cu-BTC MOF decreased significantly the number of leukocytes in the peritoneal cavity of rodents as well as reduced levels of cytokines and nitric oxide production.     

An investigation into the predictive ability of rehabilitation clinicians

Purpose: There is increasing pressure by providers, purchasers and recipients of service within the United Kingdom for a more accurate prediction of rehabilitation outcomes. The purpose of this research was to investigate how accurately clinicians were predicting rehabilitation outcomes. Method: The study was carried out among 47 patients admitted to a general rehabilitation unit. The Functional Independence Measure and Functional Assessment Measure (FAM) were used as the outcome measure. Results: The results showed a statistically significant positive correlation between goal scores and discharge scores as a total population using Spearmans correlation co-efficient. When breaking the sample into an orthopaedic and CVA population, the predictive ability for the orthopaedic population was consistently higher than for the CVA population. Conclusions: The results of this study suggest that the predictive ability of clinicians is good for the rehabilitation population although the prediction is consistently better with the orthopaedic population than the CVA population.     

根管充填糊剂对根管常见混合细菌的体外抑制作用

目的：评价3种根管充填材料在体外根充模型中对根管常见混合细菌的抑制作用。方法收集因正畸治疗而新鲜拔除的下颌双尖牙48颗,常规制备根管,随机分为4组（每组12颗）。实验组分为3组,分别用AH-Plus糊剂、Vitapex糊剂和氧化锌丁香油糊剂加牙胶尖作根管充填,对照组不作充填。根充后行冷热循环处理。使用国际参考菌株变异链球菌、粘性放线菌、嗜酸乳杆菌、粪肠球菌、殊异韦永氏菌、牙龈卟啉菌和核梭杆菌。将等体积混合制备成的混合菌液封入根管。孵育后截取根上1/3、根中1/3、根尖1/3,进行细菌采样、培养,观察细菌菌落数。利用ANOVA （P=0.05）软件,分析各组间的差异。结果所有的样本均培养出细菌。粪肠球菌在根管的所有部位均有较高的检出率。根管残留细菌总数比较,在根上1/3 Vitapex糊剂抑菌作用优于AH-Plus,而在根尖1/3 AH-Plus糊剂抑菌作用优于Vitapex。结论根尖1/3处的抑菌作用而言,AH-Plus糊剂优于Vitapex糊剂和传统的氧化锌丁香油糊剂,更具临床意义。     

Isogoniotriol衍生物的合成及体外抑制肿瘤活性

目 研究goniotriol抗肿瘤作用的构效关系。方法 以α－D－葡庚糖酸－δ－内酯为原料经9步反应，合成了12个isogoniotriol衍生物，他们的结构经IR,^1H-NMR,MS和元素分析证实。经MTT法筛选了衍生物的抗肿瘤活性。结果 10个化合物（8b,8c,8d,8e,8f,9b,9c,9d,9e,9f)为新化合物，该类化合物（8b,8c,8f)体外对多种瘤株（A2780,HCT-8,Bel742,KB)抑制强度高于8（R）－O－内桂酰基－goniotriol，但化合物（8d,8e,9b,9e,9d,9e,9f)抑制作用明显低于8（R）－O－内桂酰基－goniotriol。结论 goniotriol衍生物的8R构型为其活性的关键构型。     

The effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acute stroke: a randomized controlled study

Objective: The aim of this study was to investigate the effects of Nintendo Wii^TM-based balance and upper extremity training on activities of daily living and quality of life in patients with subacute stroke. Methods: 42 adults with stroke (mean age (SD) = 58.04 (16.56) years and mean time since stroke (SD) = (55.2 ± 22.02 days (～8 weeks)) were included in the study. Participants were enrolled from the rehabilitation department of a medical center (a single inpatient rehabilitation facility). Participants were randomly assigned to Nintendo Wii group (n = 20) or Bobath neurodevelopmental treatment (NDT) (n = 22). The treatments were applied for 10 weeks (45–60 minutes/day, 3 days/week) for both of two groups. Nintendo Wii group used five games selected from the Wii sports and Wii Fit packages for upper limb and balance training, respectively. The patients in Bobath NDT group were applied a therapy program included upper extremity activites, strength, balance gait and functional training. The functional independence in daily life activities and health-related quality of life was assessed with Functional Independence Measure (FIM) and Nottingham Health Profile (NHP), respectively. Participant's treatment satisfaction was recorded by using Visual Analogue Scale. A second evaluation (FIM and NHP) occurred after 10 weeks at the end of rehabilitative treatment (post-training). Treatment satisfaction was measured after 10 sessions. Results: There were significant difference between FIM and NHP values in NDT and Nintendo Wii group (p < 0.05). However, a significant difference was not found between the groups with regard to FIM and NHP (p > 0.05). The patients in Nintendo Wii group were detected to be better satisfied from the therapy (p < 0.05). A significant difference was found between subparameters and total FIM score, all subparameters and total NHP score in both groups (p < 0.05). Conclusion: These findings suggested that the Nintendo Wii training was as effective as Bobath NDT on daily living functions and quality of life in subacute stroke patients.