Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002395 (Alzheimer's disease)
 110,584 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a re-analysis of eight case-control studies on Alzheimer's disease we explored several medical conditions that had previously been suggested as possible risk factors for Alzheimer's disease. History of hypothyroidism was increased in cases as compared to controls (relative risk 2.3; 95% confidence interval 1.0-5.4). Severe headaches and migraine were inversely related to Alzheimer's disease (relative risk 0.7; 95% confidence interval 0.5-1.0). More cases than controls reported epilepsy before onset of Alzheimer's disease (relative risk 1.6; 95% confidence interval 0.7-3.5), especially for epilepsy with an onset within 10 years of onset of dementia. Neurotropic viruses, allergic conditions, general anaesthesia and blood transfusions were not associated with Alzheimer's disease.
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PMID:Medical history and the risk of Alzheimer's disease: a collaborative re-analysis of case-control studies. EURODEM Risk Factors Research Group. 183 52

The hemodynamic modifications during anesthesia induction with etomidat or thiopentalum, with and without pretreatment with fentanyl, were studied in 60 ASA I-II patients. The patients were randomly divided into six subgroups, as a function of the induction agent (etomidat, 0.15 mg/kg, or thiopentalum, 3 mg/kg) and of the pretreatment used (fentanyl, 5 micrograms/kg, or 0.9% 1 ml/kg saline solution). Systolic, diastolic ATs and pulse were followed and measured during induction and after tracheal intubation. During induction the presence or absence of the thoracic rigidity, after fentanyl administration, and also the appearance of myoclonias and of local pain after etomidat injection were noted. Measurement of hemodynamic constants showed, in the control subgroups unprotected by fentanyl, that AT and pulse frequency increase following laryngoscopy and intubation irrespective of the induction agent used. Association of thiopentalum with fentanyl influenced partially tachycardia and postintubation hypertension. Administration of 5 micrograms/kg fentanyl prevented the SAT and pulse modifications but not the DAT variation. Association of 10 micrograms/kg fentanyl ensured a complete protective effect versus the tracheal intubation but, it led, first, to a SAT decrease by intensification of the myocardial depressing effect of the barbiturate. On the other hand, use of fentanyl as induction adjuvant with etomidat ensured the blockage of the pressure response to intubation, with hemodynamic stability during anesthesia induction, irrespective of the dose of fentanyl injected. Thoracic rigidity and the side effects generated by etomidate were absent.
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PMID:[The effect of fentanyl as an adjuvant to etomidate and thiopental on the hemodynamic response to the induction of anesthesia and endotracheal intubation]. 253 39

In 1984-85, the authors assessed the reliability of surrogate respondents to provide interview data for the specific items of a case-control study of Alzheimer's disease conducted in Italy. For all questions of the interview, responses of 52 non-demented subjects were compared to responses of their next-of-kin. In 21-27% of the pairs the next-of-kin was unable to answer questions about general anesthesia, antacid drug use, and age of mother and father at index birth. However, the surrogate respondent was able to answer 45 of 57 tested items with agreement greater than 80%. Questions about use of hard liquor and behavior pattern yielded agreement of 71-75%, while those about number of jobs, and number of cigarettes per day yielded 62-63% agreement. For those who provided information about antacid drug use, agreement was poor. These findings are encouraging for the use of next-of-kin respondents in case-control studies of Alzheimer's disease or other neurologic conditions for which the subject cannot provide historical information.
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PMID:The use of surrogate respondents to obtain questionnaire data in case-control studies of neurologic diseases. 379 41

Cholinergic neurons innervate many areas of the brain and the disruption of acetylcholine neurotransmission at the muscarinic receptors in these areas produces dysfunction in a wide variety of mental, emotional and physiological activities. A side effect of many psychoactive drugs is the blockade of muscarinic receptors and this can result in a marked reduction of acetylcholine neural function particularly in elderly patients receiving 2 or more such drugs, and mimic the mental impairments seen in Alzheimer's Disease. A battery of mental status and short term memory tests was given the day before and 45 minutes after the administration of 0.005 mg/kg scopolamine or saline as presurgery medication to 30 normal patients over 60 years of age scheduled for lower body surgery. Total antimuscarinic activity was determined using a competitive binding assay in a 10 ml sample of blood taken from all patients after the pretest and again at the time of surgery, and in a 2 ml sample of cerebral spinal fluid taken from patients receiving spinal anesthesia immediately prior to administering the anaesthetic. The very low dose of scopolamine given to these patients produced antimuscarinic activity equivalent to 100 pmoles atropine in serum and 74 pmoles atropine in CSF. This resulted in a significant impairment of short term memory but had no significant effect on global scores on the Mini Mental State nor on the Delirium Check List.
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PMID:Mental dysfunction and the blockade of muscarinic receptors in the brains of the normal elderly. 408 89

Despite major advances in cardiopulmonary bypass technology, surgical techniques, and anesthesia management, central nervous system complications remain a common problem after cardiopulmonary bypass. The etiology of neuropsychologic dysfunction after cardiopulmonary bypass remains unresolved and is probably multifactorial. Demographic predictors of cognitive decline include age and years of education; perioperative factors including number of cerebral emboli, temperature, mean arterial pressure, and jugular bulb oxygen saturation have varying predictive power. Recent data suggest a genetic predisposition for cognitive decline after cardiac surgery in patients possessing the apolipoprotein E epsilon-4 allele, known to be associated with late-onset and sporadic forms of Alzheimer's disease. Predicting patients at risk for cognitive decline allows the possibility of many important interventions. Predictive power and weapons to reduce cellular injury associated with neurologic insults lend hope of a future ability to markedly decrease the impact of cardiopulmonary bypass on short-term and long-term neurologic, cognitive, and quality-of-life outcomes.
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PMID:Predictors of cognitive decline after cardiac operation. 773 62

Patients with Alzheimer's disease (AD) who have a late onset of dementia may represent a subgroup of AD that has a unique multifactorial/genetic profile. It was hypothesized in the present study that if external factors interact with a biological or genetic susceptibility in at least some subsets of patients with AD, these factors may accelerate the manifestation of the disease. The cumulative exposure to different types of general and major regional anesthetics prior to the onset of dementia was calculated in a population-based study of incident cases of AD residing in Rochester, MN, for more than 40 years preceding the onset of dementia (N = 252). Correlational analysis revealed that age of onset was inversely related to cumulative exposure to general and spinal anesthesia before the age of 50, whereas there was no, or an expected positive, correlation for anesthetic exposure after 50 years. These findings may suggest that the manifestation of dementia in AD patients may be related to exposure to external factors at an earlier age.
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PMID:Early and midlife exposure to anesthesia and age of onset of Alzheimer's disease. 781 11

We gave anesthesia to a 60-year-old female patient in stage III (end stage) of Alzheimer's disease for sigmoidectomy. She had myoclonus and parkinsonism and it was not possible to communicate with her verbally. After induction of anesthesia with thiopental, she had a catheter inserted into epidural space. Without endotracheal intubation, anesthesia was maintained with nitrous oxide, oxygen and isoflurane under spontaneous ventilation supplemented with mepivacaine from the epidural catheter. No muscle relaxant was used. Recovery from the anesthesia was uneventful. No complication was observed during anesthesia and postoperatively.
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PMID:[Anesthetic management of a patient with Alzheimer's disease]. 835 Apr 71

Differences between vascular dementia and Alzheimer's dementia may be present in both risk factors and in behavioral manifestations. Behavioral distinctions may be apparent only at particular stages of the disease process, but comparisons at different stages require a large number of subjects. The California Alzheimer Disease Diagnostic and Treatment Center Program has collected data on a large number of subjects with dementia. We examined differences in risk factors and in behaviors in 502 subjects with vascular dementia and 810 subjects with probable Alzheimer's dementia. With respect to risk factors, vascular dementia subjects were more likely to have a history of general anesthesia. We found no difference in history of closed head trauma, family history of dementia, or cigarette smoking, suggesting that these factors are less likely to have a disease-specific etiologic role. With respect to behaviors, subjects with vascular dementia were more likely to have depression in all stages of dementia. Subjects with Alzheimer's dementia were more likely to exhibit wandering in the middle or late stages. Subjects were similar in five other behavioral factors in the three stages studied. We conclude that general anesthesia is a risk factor for vascular dementia and that depression is more prevalent in vascular dementia, while wandering is more characteristic of Alzheimer's dementia.
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PMID:Risk factor and behavioral differences between vascular and Alzheimer's dementias: the pathway to end-stage disease. 842 68

The association between dementia and hip fracture was studied in a representative sample of 85-year olds (N = 485). The diagnosis of dementia was made according to the DSM-III-R. The prevalence of hip fracture was obtained by history and inspection of the hip. Bone mineral density was measured with dual photon absorptiometry of the right calcaneus. Hip fracture was associated with both Alzheimer's disease (p < 0.01) and vascular dementia (p < 0.01) in women, but not in men. Among women with dementia, the rate of hip fracture was more than twice that found in the general population (32.7% vs 13.6%). Bone density was not associated with dementia or hip fracture. Body mass index and body weight were lower in women with dementia and in women with hip fracture. The prevalence of hip fracture was also increased in subjects who used psychotropic drugs, especially tricyclic antidepressants. A logistic multiple regression analysis showed that dementia, use of antidepressants and gender independently contributed to hip fracture. The reason why subjects with dementia are at increased risk for hip fractures may be that these subjects have a defective neuromuscular regulation, gait apraxia, use more antidepressants, and have a lower body mass index. Another explanation of the association may be that surgery and anesthesia give rise to systemic hypotension that leads to cerebral hypoperfusion and ischemic and neuronal death in vulnerable brain areas, and as a consequence may lead to dementia or worsen the symptoms in subjects already affected by dementia.
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PMID:A population-based study on the association between dementia and hip fractures in 85-year olds. 886 94

Succinic semialdehyde reductase (SSR) that catalyzes the reduction of succinic semialdehyde (SSA) to gamma-hydroxybutyrate (GHB) has been identified as one of the NADPH-dependent aldehyde reductases. Reduction of SSA to GHB strongly supports the proposal that GHB biosynthesis may be an important step in the GABA shunt. It is pharmacologically significant in anesthesia, evoking the state of sleep, and an increase in brain dopamine level. Monoclonal antibodies against bovine brain succinic semialdehyde reductase were produced. Using the anti-succinic semialdehyde reductase antibodies, we investigated the distribution of brain succinic semialdehyde reductase in rat brain. The brain tissues were sectioned with a basis on the rat brain atlas of Paxinos and were stained by the immunoperoxidase staining method using monoclonal antibodies. In the section of the frontal lobe, immunoreactive cells were observed in the lateral septal area, the ventral pallidum, which belongs to the substantia innominata. We could observe immunoreactive cells in the reticular thalamic nucleus, which is closely related with 'sleeping', the basal nuclei of Meynert, which is associated with Alzheimer's disease, and hypothalamic nuclei. Immunoreactive cells were also shown in raphe nuclei or the reticular formation of the midbrain, cerebellum, and inferior olivary nuclei of the medulla oblongata. Succinic semialdehyde reductase-immunoreactive cells were distributed extensively in rat brain, especially immunoreactive cells were strongly observed in the areas associated with the limbic system and reticular formation.
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PMID:Distribution of succinic semialdehyde reductase in rat brain. 908 59


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