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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over 2300 patients referred to a geriatric outreach program were evaluated for the relationships between diagnosis and (1) referral reason, (2) referral source, and (3) age. Referral reason was only a clue to the eventual diagnosis. Patients referred for depression received a diagnosis of depression in only 46 per cent of such referrals, and patients referred for forgetfulness or confusion received a diagnosis of dementia in only 37 per cent of these referrals. Families were most likely to refer demented patients, and health agencies to refer depressed patients. Apartment managers and housing authority representatives were least likely to refer depressed patients and most likely to refer paranoid patients. The rate for diagnosis of dementia increased with age, whereas the rates for diagnoses of depression and alcohol/drug abuse decreased with age.
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PMID:Psychiatric diagnoses among geriatric patients seen in an outreach program. 709 55

Some Canadians who served in the military in the Persian Gulf 4 years ago complain of a range of symptoms commonly described as Gulf War syndrome. Although the syndrome is not recognized as a clinical entity, symptoms include fatigue, lack of sleep, depression, cognitive problems, rashes, bone aches, lassitude, lack of motivation, forgetfulness, mood changes irritability and diarrhea. The medical branch of the Department of National Defence has established programs to inform, guide diagnosis and reach out to symptomatic veterans of the Persian Gulf conflict. Civilian physicians who provide similar care to military personnel who participated in the conflict are invited to call the medical branch (613 996-3752) for further information.
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PMID:Veterans worry that unexplained medical problems a legacy of service during Gulf War. 769 87

A sample of 1,250 Black elderly individuals was examined to assess the prevalence and correlates of self-reported memory problems. More than 48.3 percent of the sample reported poor memory and forgetfulness as either a very (17.9%) or somewhat (30.4%) serious problem. Multivariate logistic regression was employed to detect the significant predictors of self-reported memory problems. According to our data, those Black elderly individuals who have hearing problems, who report a higher number of stressful life-events, who experience a higher level of depression, and who suffer from poorer health are more likely to complain of memory problems.
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PMID:The effects of depression, health status, and stressful life-events on self-reported memory problems among aged blacks. 796 Jan 82

Between January 1991 and January 1993, 265 patients who fulfilled the CDC criteria of the working case definition of Chronic Fatigue Syndrome (CFS) have been observed at our Institution and submitted for clinical and laboratory evaluation. One hundred and sixty-three patients were females and 102 males, the median age was 35 years (range 4-55 years); all patients reported profound and prolonged fatigue, lasting for a median of 3 years (range 6 months-10 years), preceded or accompanied at appearance by fever in 185 cases, and neuropsychologic problems including inability to concentrate, difficulty in thinking, confusion, irritability, forgetfulness, and depression. The fatigue was so severe that it required 102 patients to stop their working activities for a period of time ranging from 3 months to 2 years (range 7 months). In 40 consecutive patients a comprehensive immunologic testing by single and two-colour flow cytometry was performed and results compared with a group of 35 healthy, age- and sex-matched controls. Whilst no significant differences were found in the absolute numbers of circulating total T cells (CD3+) and of total helper/inducer (CD4+) or suppressor/cytotoxic (CD8+) T cells, an evident reduction in CD3-/CD16+ and CD57+/CD56+ NK lymphocytes along with an expansion of the CD8+/CD56+ and CD16-/CD56+ NK subsets, were found in the CFS group. In addition, CD56+ NK cells from CFS subjects were found to express an increased amount of cell adhesion molecules (CD11b, CD11c, CD54) and activation antigens (CD38). Both the percentage and absolute numbers of CD4+ T cells bearing the CD45RA antigen appeared significantly reduced in CFS patients, and CD4+ T lymphocytes from CFS subjects displayed an increased expression of the intercellular adhesion molecule-1 (ICAM-1/CD54). Finally, the total numbers of circulating (CD19+) B lymphocytes, were significantly higher in CFS cases than in controls, and in 11 out of 30 CFS patients the increase in circulating B cells was sustained by the expansion of the CD5+/CD19+ subset of B lymphocytes. We conclude that CFS is a syndrome not previously described in Italy, with already known clinical characteristics and appears to be associated with several immunologic abnormalities, including those reported previously in cohort of patients from different countries. We also show for the first time that CD56- NK cell subsets from CFS patients display an abnormally increased expression of cell adhesion molecules and activation markers.
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PMID:Immunological abnormalities in patients with chronic fatigue syndrome. 799 49

The neuropsychological functioning of five men suffering alleged physical, cognitive and behavioural changes following exposure to methylene diphenyl diisocyanate (MDI), an industrial chemical, was investigated in the present study. At the time of assessment, four of the five patients remained symptomatic despite having no contact with MDI for periods ranging from 5 to 9 months. All patients reported experiencing subjective symptoms consisting of respiratory distress, headaches, depression, irritability, forgetfulness, decreased calculating ability, word-finding problems and reduced concentration. While the pattern of neuropsychological deficits varied among the patients, common findings for the group included intact psychomotor, psychosensory, visuographic and language functions accompanied by deceased concentration, mental efficiency, rate of information processing, learning ability and abstract reasoning. All five patients also revealed significant emotional distress on an objective personality measure. In general, the neuropsychological test data support the presence of behavioural and cognitive correlates of CNS injury following exposure to MDI.
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PMID:Neuropsychological toxicology of methylene diphenyl diisocyanate: a report of five cases. 800 86

The authors investigated 40 heart transplant recipients and their partners to determine both the partner's quality of life upon transplantation and the experiences of both patient and partner with compliance with the medical regimen. Data on sleep disturbances, social isolation, emotional reactions, depression, anxiety, partner's apprehension, social support and compliance (regarding behaviour and emotional experience) were obtained approximately 21 months after transplantation. Compared to related study groups, partners did not experience more problems in sleep, social isolation, emotional reactions, depression and anxiety. Patients overestimated the apprehension of their partners significantly (p < 0.0001). Generally speaking, with the exception of three items relating to eating fish, canned food and forgetfulness in medicine intake, patients and partners agreed with respect to actual compliance behaviour. Lowest compliance concerned regular physical exercise: 28%. Both patient and partner insisted that they had scarcely any emotional problem with the regimen. Further systematic research is needed to bring to light factors that affect compliance as well as adequate methods to bring about an improvement therein.
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PMID:Compliance with the medical regimen and partner's quality of life after heart transplantation. 840 56

The consequences for cognitive functioning of normal aging, depression and dementia are well known. However, the borderline between normal and pathological cognitive aging is less well understood. Recently, it has been found that it is important to differentiate between 'successful', 'usual' and pathological cognitive aging. This article reviews existing views on this borderline. Recently, it has been found that health-related factors, or biological life events, may determine the rate of cognitive aging. Various different, but similar, diagnostic descriptions of age-related cognitive dysfunction exist simultaneously: benign senescent forgetfulness, malignant senescent forgetfulness, age-associated memory impairment, age-consistent memory impairment, late-life forgetfulness, mild cognitive changes (subthreshold) and cognitive impairment disorders are some examples of different diagnostic categories. There are also various diagnostic tools to obtain these experimental diagnoses; for example, the Global Deterioration Scale, the Clinical Dementia Rating Scale and the Cambridge Mental Disorders of the Elderly Examination. A diagnosis is considered important for the early detection of dementia. Pharmacological treatments are still in the experimental stage. Improvement of cognitive function has particularly been studied in clinical trials with groups of patients with Alzheimer's disease as well as patient groups with age-associated memory impairment. Future strategies may orient more towards treating symptoms of cognitive dysfunction, probably also on the basis of diagnosis of health-related factors, in age-related cognitive decline and depression.
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PMID:Cognitive impairment in elderly people. Predisposing factors and implications for experimental drug studies. 860 Oct 53

In this study we examined the prevalence and covariates of forgetfulness in a large sample of almost 2,000 subjects in the age range twenty-four to eighty-six years. Nearly 40 percent of the participants considered themselves to be forgetful. There was a systematic increase in the prevalence of forgetfulness with age, from 29 percent in the young age group to 52 percent in the oldest age group. Forgetfulness was not considered to be a serious problem in terms of perceived hindrance and worry by most subjects, independent of their age. Age, depression, and subjective health (especially complaints about vitality) acted as covariates of forgetfulness. Gender and education had no effect on the prevalence of forgetfulness. The younger adults ascribed their forgetfulness more to potentially reversible and manageable memory-extrinsic causes such as tension and emotional problems, whereas the older adults mentioned less manageable and more or less irreversible memory-intrinsic causes such as aging more often.
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PMID:Prevalence and covariates of subjective forgetfulness in a normal population in The Netherlands. 943 76

Over the next year, additional persons in Maryland may be at risk for exposure of toxic Pfiesteria or morphologically related organisms. These persons may present with a variety of memory and other behavioral complaints. This paper examines the kinds of complaints that persons with a documented Pfiesteria-related syndrome have compared to a nonexposed control group. The exposed group was more likely to report difficulties with concentration, forgetfulness, prospective memory, and information overload as well as feelings of confusion, bewilderment, and uncertainty as direct effects of toxin exposure. The exposed group was also more likely to report feeling uneasy, on edge, nervous, and shaky, which is probably a reaction to their newly acquired cognitive deficits and uncertainty about their recovery. In contrast, retrograde memory loss, disturbances of language or social behavior, depression, anger, hostility, or diminished activity levels are not symptoms that exposed persons are likely to report.
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PMID:Neurobehavioral complaints of symptomatic persons exposed to Pfiesteria piscicida or morphologically related organisms. 960 Nov 98

Selective serotonin reuptake inhibitors may be associated with new adverse events after abrupt discontinuation. Hypothesizing that the long half-life of fluoxetine would be protective, this study analyzed the effects of abrupt fluoxetine discontinuation during a randomized, double-blind, placebo-controlled study of depression maintenance treatment. After 12 weeks of fluoxetine treatment (20 mg/day), 395 responders were abruptly randomized to placebo (N = 96) or to continued fluoxetine (N = 299). Patients were seen at weeks 1, 2, 4, and 6 after randomization. Reports of new or worsened adverse events were similar for both groups at each visit after randomization. Patient discontinuations related to adverse events were also similar in both groups. Mild, self-limited lightheadedness or dizziness occurred in a small percentage of patients who discontinued fluoxetine treatment but was of little clinical significance. No cluster of symptoms suggestive of a discontinuation syndrome was observed. Abrupt discontinuation of fluoxetine treatment was well tolerated and did not seem to be associated with significant clinical risk. Fluoxetine may offer a potential safety advantage over shorter-acting agents with respect to treatment interruption and/or discontinuation and may be a better choice for those patients who are likely to miss doses because of travel or forgetfulness.
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PMID:Safety of abrupt discontinuation of fluoxetine: a randomized, placebo-controlled study. 961 77


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