Denial of Human Rights: We Must Change the Paradigm of Dementia Care

In far too many instances treatment of persons with dementia has reflected a fundamental denial of basic human rights. At times, these individuals are treated worse than the treatment of animals when the five basic freedoms of animals, described by Pachana in her editorial, are implemented. A number of such examples of dehumanizing (and “de-animalizing”) persons with dementia are presented. A case is made for the position that this is the direct result of the “medicalization” of dementia and “Alzheimer Disease.” This has led to the disenfranchisement of persons with dementia and their caregivers regarding the treatment of dementia, while medical “expertise” has led to a paradigm of learned helplessness while waiting for “the cure.” While the medicalization of dementia has been a financial success in terms of funding failed researcher to find a cure, it has been a catastrophe for the quality of life of persons with dementia and their caregivers. It is time to take control of the treatment of dementia back, and especially to listen to the voices of persons with dementia. It is time to take action NOW – to become disruptive to the current paradigm. The emperor and his cure have no clothes. We deserve better. We must make this change in paradigm our mission, to demand it, and to accept nothing less. Power to the people.     

Core body temperature in the elderly and factors which influence its measurement

Several studies have reported that core body temperature decreases with age and has greater variability in older populations. Furthermore, oral measurement, the most frequently used clinical method for determining fever, may not accurately reflect core body temperature. This study was designed to compare accurate measurements of oral and core body temperatures in a group of 93 healthy subjects, aged 62-96, under controlled conditions. Increasing age, presence of dentures, and type of thermometer were examined to determine if they affect body temperature measurements. Core temperatures did not show a negative relationship with advancing age (r = -0.02) nor did variation in temperatures increase with age. Neither the type of thermometer nor the presence of dentures significantly affected the measurement of temperature.     

Transient occurrence of extrachromosomal DNA of an Arabidopsis thaliana transposon-like element, Tat1.

Analysis of 11 genomic clones containing the S-adenosylmethionine synthetase 1 gene (sam1) of Arabidopsis thaliana revealed the presence of a 431-base-pair (bp) insertion in the 3' end of sam1 in one of these clones. The inserted sequence, called Tat1, shows structural features of a transposon. It is flanked by a 5-bp duplication of the target site DNA and has 13-bp inverted repeats at its termini. Two highly homologous elements situated in a different genomic context were isolated from a genomic library. Genomic Southern analysis indicates that there are at least four copies of Tat1 present in the A. thaliana ecotype Columbia genome. Different hybridization patterns are observed with DNAs derived from different ecotypes of Arabidopsis thaliana, indicating that the element has moved since the divergence of these ecotypes. In two populations of A. thaliana, linear extrachromosomal Tat1-homologous DNA has been observed. The presented data are consistent with the hypothesis that Tat1 is an active transposable element.     

一项对原发进行性多发性硬化症患者认知功能的纵向研究

有关多发性硬化症患者认知功能的纵向研究很少，并且上述研究的结果也不明确，迄今尚无专门关于原发进行性多发性硬化症（PPMS）病例系列的连续神经心理学资料。横断面分析揭示，PPMS患者的认知功能与磁共振成像（MRI）参数之间显著相关。本研究持续2年时间对来源于5个欧洲中心的99例PPMS患者的认知功能和MRI改变进行探讨。采用简易可重复问卷（一种推理能力测试）和抑郁量表每隔12个月对患者进行评估，同时在每个时间点对T1低信号负荷、T2损伤负荷和部分脑体积的MRI参数进行测算。基线和2年时患者的平均认知功能得分间无显著差异。然而，1／3患者的单独测试得分表现出绝对的认知功能下降。研究结果提示，纳入研究时的初始认知状态是2年后认知能力的一个可靠预测指标。认知功能改变和MRI改变间仅有少数几项指标显著相关，值得一提的是T1低信号负荷与2项注意力测试任务相关（r=-0．266，P=0．017；r=-0．303，P=0．012），可能是由多种因素造成认知功能和MRI参数间的这种弱相关。     

A randomized controlled trial of electromagnetic therapy in the primary care management of venous leg ulceration

OBJECTIVE: The aim was to establish the potential efficacy, tolerabilityand side-effect profile of electromagnetic therapy as an adjunctto conventional dressings in the treatment of venous leg ulcers. METHOD: A prospective, randomized, double blind controlled clinicaltrial was carried out in a dedicated leg ulcer clinic basedin one urban general practice. Nineteen patients with leg ulcersof confirmed venous aetiology were assessed. The main outcomemeasures were rate and scale of venous leg ulcer healing, changesin patient-reported pain levels, quality of life, degree ofmobility, side effect profile and acceptability to patientsand staff. RESULTS: Sixty-eight per cent of patients attending this dedicated clinicachieved improvements in the size of their ulcer (4, 21%, healedfully) and in reduced pain levels (P < 0.05) during the trial,despite the chronicity of ulcer histories. Patients treatedwith electromagnetic therapy at 800 Hz were found at day 50to have significantly greater healing (P < 0.05) and paincontrol (P < 0.05) than placebo therapy or treatment with600 Hz. All patients reported improved mobility at the end ofthe study. The electromagnetic therapy was well tolerated bypatients, with no differences between groups in reporting adverseevents, and proved acceptable to staff. CONCLUSION: Despite the small numbers in this pilot study, electromagnetictherapy provided significant gains in the healing of venousleg ulcers and reduction in pain. Keywords. Electromagnetic therapy, RCT, leg ulcers, primary care.