Understanding the financial impact of a diagnosis of young onset dementia on individuals and families in the United Kingdom: Results of an online survey

Although literature on postdiagnostic support for people affected by young onset dementia acknowledges financial concerns, this topic has remained underresearched. The aim of this study was to explore the financial impact of a diagnosis of young onset dementia on individuals and families. An online survey, comprising binary yes/no, multiple-response and open-ended questions, was codesigned with people living with young onset dementia. The survey was promoted via networks and online platforms. Data were collected from August to October 2019. Survey respondents across the United Kingdom (n = 55) who had received a diagnosis of young onset dementia were aged between 45 and 64, were at different stages of dementia and had been diagnosed with thirteen different types of dementia. Of the 55 respondents, 71% (n = 39) had received assistance from family members when completing the survey. The main financial impact of a diagnosis of young onset dementia resulted from premature loss of income and reduced and often deferred pension entitlements. In some cases, care-costs became unaffordable. Lack of clarity of processes and procedures around needs assessments, carers' assessments and financial assessments by different organisations resulted in some families having to ask for legal advice and, in some cases, involved lengthy appeal processes. Future research needs to involve Adult Social Care and Third Sector organisations to help codesign and test financial management interventions to support people affected by this progressive health condition.     

Renal effects of recombinant prolactin in anaesthetized rats.

OBJECTIVE: To re-examine the controversial possibility that prolactin exerts renal effects, using recombinant mouse prolactin (rmP), in the presence and absence of circulating vasopressin. DESIGN: In experiment 1, the renal effects of rmP were examined in anaesthetized Brattleboro rats with hereditary hypothalamic diabetes insipidus (BDI) lacking circulating vasopressin and normal animals of the parent Long Evans (LE) strain. In experiment 2, salt and water excretion were studied in fluid-loaded normal Sprague-Dawley (SD) rats, some of which received rmP. METHODS: In experiment 1, BDI and LE rats maintained in fluid balance were infused i.v. with each of three concentrations of rmP (10, 20 and 40 microg/ml per h) or maintained on 150 mmol/l NaCl vehicle (controls). In experiment 2, the SD rats were infused with 75 mmol/l NaCl in order to induce a state of diuresis comparable to that of BDI rats, some of them then receiving the rmP i.v. RESULTS: A profound rmP-induced dose-dependent decrease in urine excretion (P<0.005) and a lesser decrease in sodium excretion in the BDI rats was in marked contrast with the small but significant increase in urine excretion in the LE rats compared with controls (P<0.025). The rmP-infused fluid-loaded SD rats also demonstrated a significant (P<0.05) dose-related antidiuresis compared with the control animals, in addition to a decrease in sodium excretion. CONCLUSIONS: These results show that prolactin has a profound antidiuretic effect in the absence of circulating vasopressin. In contrast, when vasopressin is present in the circulation rmP has a small, but opposite, diuretic effect. Thus the use of a recombinant prolactin has provided evidence for renal effects of this hormone which are modified in the presence of the circulating neurohypophysial hormone vasopressin.     

Gastric precancerous lesions in first degree relatives of patients with known gastric cancer: a cross-sectional prospective study in Guilan Province, north of Iran

Background & Objectives: In patients with gastric cancer, the most frequently reported family historyof cancer also involves the stomach. The aim of this study was to assess the presence of gastric precancerouslesions in first-degree relatives of patients with gastric cancer and to compare the obtained results with thoseof individuals with no such family history. Methods: Between 2007 and 2009, 503 consecutive persons morethan 30 years old were enrolled in the study covering siblings, parents or children of patients with confirmedadenocarcinoma of stomach. The control group was made up of 592 patients who were synchronously undergoingupper gastrointestinal endoscopy for evaluation of dyspepsia without gastric cancer or any family history. Allsubjects were endoscopically examined. Results: The overall prevalence of Helicobacter pylori was 77.7% in thecancer relatives and in 75.7% in the control group. Chronic gastritis was found in 90.4% vs. 81.1% (P<0.001).Regarding histological findings, 37(7.4%) of the study group had atrophy vs. 12(1.7%) in the control group(P<0.001), while no difference was observed for intestinal metaplasia (20.3%vs. 21.6%, P=0.58). Dysplasia wereshown in 4% of cancer relatives but only 0.4% of the control group (P<0.001). There was no gender specificity.Conclusions: Findings of our study point to great importance of screening in relatives of gastric cancer patientsin Iran.     

Colonic mucosal lysosomal enzyme activities in ulcerative colitis

Optimal assay conditions and kinetic properties of three acid hydrolase activities, acid phosphatase, arylsulfatase, and β-glucuronidase and a non-lysosomal alkaline phosphatase activity, were determined in colon mucosa from 12 normal subjects and compared to mucosa from 5 patients with ulcerative colitis. There were significant decreases in specific activities of arylsulfatase and β-glucuronidase and significant increases in specific activities of acid and alkaline phosphatase in mucosa from patients with ulcerative colitis when compared to data from normals. Abnormal acid hydrolase activities were found in all diseased portions of mucosa studied but were absent in normal specimens from patients with ulcerative colitis. Such changes in acid hydrolase activities could not be attributed to changes in kinetic properties of the enzymes, changes in binding to particulate cellular material, the presence or absence of dissociable inhibitors or stimulators of the several activities or the lymphocytic portion of the inflammatory exudate in the lamina propria. The three acid hydrolase activities appeared to behave in concert from patient to patient. Although mean activities of both acid and alkaline phosphatase increased in diseased mucosa, there was a significant negative correlation between them in individual patients. Coupled with the slight but significantly decreased inhibition of colon mucosal alkaline phosphatase activity in ulcerative colitis specimens byl-phenylalanine, this disordancy suggests different cells were responsible for the changes in acid hydrolase activities and alkaline phosphatase activity. Whereas these changes may be a result of the disease, they are also consistent with a potential pathogenetic role of lysosomal acid hydrolases in ulcerative colitis.