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Knowledge, Attitudes and Beliefs about dementia in an Urban Xhosa-Speaking Community in South Africa

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Advances in Alzheimer's Disease 2015年第2期4卷 21-36页

作者： V. Khonje C. Milligan Y. Yako M. Mabelane K. E. Borochowitz C. A. de Jager Faculty of Health Sciences University of Cape Town Cape Town South Africa dementia sa State House Cape Town South Africa Division of Geriatric Medicine Department of Medicine University of Cape Town Cape Town South Africa

Background: dementia, a debilitating condition, requires particular attention in Southern Africa where there is a dearth of prevalence data. Population ageing and other risk factors are driving an increasing incidence of dementia. However, limited knowledge and understanding may impact the attitudes and practices towards persons with dementia. Aim: To investigate the relationship between the knowledge of dementia, its effect on the attitudes and practices toward people with dementia in an urban community setting. To determine the perceived availability of services for those with dementia, the awareness of elder abuse and care-giver burden. Methods: A descriptive, cross-sectional study was performed in Khayelitsha. An interviewer administered questionnaire was used with assistance from isiXhosa speaking translators. A sample of 100 individuals was surveyed door-to-door from both the informal and formal housing settlements, using cluster random sampling methods. Results: There was deficient knowledge about dementia, with an average accuracy of 53.44% on the knowledge test. Only 10% reported knowing what dementia was. Participants had generally tolerant views about people with dementia. No significant relationship was found between knowledge and attitudes about dementia. There was a significant difference between people who would share their house with a family member with dementia or send them to nursing homes (p = 0.03). 64% of participants knew what elder abuse was. 19% knew of an elder who had been abused;amongst the most common forms reported were being locked alone in their house and being deprived of food. Conclusions: This study showed that knowledge about dementia was limited with no relationship to attitudes of high tolerance towards people with dementia. Elder abuse was well recognized, but poorly reported. Appropriate health promotion strategies and education should be conducted and further research should be done into dementia in South Africa.

关键词： dementia Carer Burden Elder Abuse Prevalence

Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse Craig S Anderson sandeep Ankolekar Lesley Cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir John Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C sandset Jeffrey L saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

Association of cardiovascular system medications with cognitive function and dementia in older adults living in nursing homes in Australia

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Journal of Geriatric Cardiology 2017年第6期14卷 407-415页

作者： Enwu Liu Suzanne M Dyer Lisa Kouladjian O'Donnell Rachel Milte Clare Bradley Stephanie L Harrison Emmanuel Gnanamanickam Craig Whitehead Maria Crotty Department of Rehabilitation Aged and Extended Care Faculty of Medicine Nursing and Health Sciences School of Health Sciences Flinders University Daw Park Australia NHMRC Cognitive Partnership Centre The University of Sydney Sydney NSW Australia Kolling Institute of Medical Research St Leonards NSW Australia and Sydney Medical School University of Sydney Sydney NSW Australia Institute for Choice University of South Australia GPO Box 2471 Adelaide SA Australia Infection & Immunity - Aboriginal Health SAHMRI PO Box 11060 Adelaide SA Australia

Objective To examine associations between cardiovascular system medication use with cognition function and diagnosis of dementia in older adults living in nursing homes in Australia. Methods As part of a cross-sectional study of 17 Australian nursing homes examining quality of life and resource use, we examined the association between cognitive impairment and cardiovascular medication use （identified using the Anatomical Therapeutic Classification System） using general linear regression and logistic regression models. People who were receiving end of life care were excluded. Results Participants included 541 residents with a mean age of 85.5 years （± 8.5）, a mean Psychogeriatric Assessment Scale–Cognitive Impairment （PAS-Cog） score of 13.3 （± 7.7）, a prevalence of cardiovascular diseases of 44% and of hypertension of 47%. Sixty-four percent of participants had been diagnosed with dementia and 72% had received cardiovascular system medications within the previous 12 months. Regression models demonstrated the use of cardiovascular medications was associated with lower （better） PAS-Cog scores [Coefficient （β） = -3.7; 95% CI： -5.2 to -2.2; P 〈 0.0001] and a lower probability of a dementia diagnosis （OR = 0.44; 95% CI： 0.26 to 0.75, P = 0.0022）. Analysis by subgroups of medications showed cardiac therapy medications （C01）, beta blocking agents （C07）, and renin-angiotensin system agents （C09） were associated with lower PAS-Cog scores （better cognition） and lower dementia diagnosis probability. Conclusions This analysis has demonstrated an association between greater cardiovascular system medication use and better cognitive status among older adults living in nursing homes. In this population, there may be differential access to health care and treatment of cardiovascular risk factors. This association warrants further investigation in large cohort studies.

关键词： Cardiovascular agents Cognitive dysfunction dementia Residential facilities

Mesenchymal stem cell-and extracellular vesicle-based therapies for Alzheimer's disease:progress,advantages,and challenges

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Neural Regeneration Research 2023年第8期18卷 1645-1651页

作者： Renata Guedes de Jesus Gonçalves Juliana Ferreira Vasques Almir Jordão da Silva-Junior Fernanda Gubert Rosalia Mendez-Otero Instituto de Biofísica Carlos Chagas Filho Universidade Federal do Rio de JaneiroRio de JaneiroBrazil Instituto Nacional de Ciência e Tecnologia em Medicina Regenerativa Rio de JaneiroBrazil Plataformas Inovadoras em Terapias Avançadas Departamento de Ciência e Tecnologia-Ministério da Saúde(DECIT-MS)Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq)Brazil Programa Redes de Pesquisa em saúde no Estado do Rio de Janeiro Rio de JaneiroBrazil Instituto de Ciências Biomédicas Universidade Federal do Rio de JaneiroRio de JaneiroBrazil Programa Redes de Pesquisa em Nanotecnologia no Estado do Rio de Janeiro Rio de JaneiroBrazil

Alzheimer's disease is a severe, highly disabling neurodegenerative disease, clinically characterized by a progressive decline in cognitive functions, and is the most common form of dementia in the elderly. For decades, the search for disease-modifying therapies has focused on the two main Alzheimer's disease histopathological hallmarks, seeking to prevent, mitigate, or clear the formation of extracellular aggregates of β-amyloid peptide and intracellular neurofibrillary tangles of tau protein, although without clinical success. Mesenchymal stem cell-based therapy has emerged as a promising alternative for the treatment of Alzheimer's disease, especially because it also targets other crucial players in the pathogenesis of the disease, such as neuroinflammation, synaptic dysfunction/loss, oxidative stress, and impaired neurogenesis. Herein, we review current knowledge of the therapeutic potential of mesenchymal stem cells and their extracellular vesicles for Alzheimer's disease, discussing the most recent findings in both preclinical and clinical trials as well as how advanced technologies have helped to overcome some limitations and contributed to stimulate the development of more effective treatments.

关键词： Alzheimer's disease amyloid-β cell therapy cell transplantation exosomes extracellular vesicles mesenchymal stem cell micro vesicles neuroinflammation tau protein

Hyperdense artery sign, symptomatic infarct swelling and effect of alteplase in acute ischaemic stroke

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Stroke & Vascular Neurology 2021年第2期6卷 238-243页

作者： Simiao Wu Grant Mair Geoff Cohen Zoe Morris Anders von Heijne Nick Bradey Lesley Cala Andre Peeters Andrew J Farrall Alessandro Adami Gillian Potter Ming Liu Richard I Lindley Peter A G sandercock Joanna M Wardlaw the IST-3 Collaborative Group Department of Neurology West China HospitalSichuan UniversityChengduSichuanChina Centre for Clinical Brain Sciences The University of EdinburghEdinburghUK Department of Clinical Sciences Danderyd HospitalStockholmSweden Neuroradiology James Cook University HospitalSouth Tees Hospital NHS TrustMiddlesbroughUK Division of Pathology and Laboratory Medicine School of MedicineThe University of Western AustraliaPerthWestern AustraliaAustralia Department of Neurology Cliniques universitaires Saint-LucBruxellesBelgium Stroke Center IRCCS Sacro Cuore Don CalabriaVeronaItaly Department of Neuroradiology Manchester Centre for Clinical NeurosciencesSalford Royal NHS Foundation TrustSalfordUK Westmead Applied Research Centre Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia The George Institute for Global Health NewtownNew South WalesAustralia UK dementia Research Institute Centre at the University of Edinburgh EdinburghUnited Kingdom 不详

Background Alteplase improves functional outcomes of patients with acute ischaemic stroke,but its effects on symptomatic infarct swelling,an adverse complication of stroke and the influence of CT hyperdense artery sign(HAS)are *** substudy of the Third International Stroke Trial aimed to investigate the association between HAS and symptomatic infarct swelling and effect of intravenous alteplase on this *** We included stroke patients whose prerandomisation scan was non-contrast ***,masked to clinical information,assessed baseline(prerandomisation)and follow-up(24-48 hours postrandomisation)CT scans for HAS,defined as an intracranial artery appearing denser than contralateral *** infarct swelling was defined as clinically significant neurological deterioration≤7 days after stroke with radiological evidence of midline shift,effacement of basal cisterns or uncal *** Among 2961 patients,HAS presence at baseline was associated with higher risk of symptomatic infarct swelling(OR 2.21;95% CI 1.42 to 3.44).Alteplase increased the risk of swelling(OR 1.69;95% CI 1.11 to 2.57),with no difference between patients with and those without baseline HAS(p=0.49).In patients with baseline HAS,alteplase reduced the proportion with HAS at follow-up(OR 0.67;95% CI 0.50 to 0.91),where HAS disappearance was associated with reduced risk of swelling(OR 0.25,95% CI 0.14 to 0.47).Conclusion Although alteplase was associated with increased risk of symptomatic infarct swelling in patients with or without baseline HAS,it was also associated with accelerated clearance of HAS,which in return reduced swelling,providing further mechanistic insights to underpin the benefits of alteplase.

关键词： infarct swelling effect

痴呆症病人家庭照顾者社会支持及相关因素研究

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护理研究 2019年第14期33卷 2460-2463页

作者：王婧罗艳 Lily Dongxia Xiao 李小妹西安交通大学护理学系 710061 sa5001 College of Nursing and Health SciencesFlinders University

[目的]探讨居家痴呆症病人家庭照顾者社会支持及其相关因素。[方法]采用多点横断面研究设计,应用一般资料问卷、社会支持评定量表和照顾者负担量表对152位痴呆症病人的家庭照顾者进行测评,分析照顾者社会支持情况,探讨其相关因素及其对... 详细信息

[目的]探讨居家痴呆症病人家庭照顾者社会支持及其相关因素。[方法]采用多点横断面研究设计,应用一般资料问卷、社会支持评定量表和照顾者负担量表对152位痴呆症病人的家庭照顾者进行测评,分析照顾者社会支持情况,探讨其相关因素及其对照顾者负担的影响。[结果]本组研究对象社会支持得分为(32.26±5.51)分,显著低于我国常模(t=-5.158,P=0.000);单因素分析显示配偶照顾者、不在业的照顾者、教育程度较低的照顾者以及与病人同住的照顾者社会支持总分或分维度得分较低(P<0.05),且照顾者年龄及每周照顾时间与社会支持总分或分维度得分呈负相关(P<0.05);除生理性负担和情感性负担两个维度外,照顾者负担总分及其他维度得分与不同维度的社会支持得分呈负相关(P<0.05)。[结论]本组居家痴呆症病人家庭照顾者社会支持情况不容乐观,针对社会支持的弱势群体、构建符合照顾者需求与特点的支持性干预措施意义重大,以期改善照顾者身心状况与照顾质量,提高照顾者与痴呆症病人双方的生活质量。

关键词：痴呆症阿尔茨海默病家庭照顾者社会支持照顾负担影响因素

Diabetes and cognitive function:An evidence-based current perspective

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World Journal of Diabetes 2023年第2期14卷 92-109页

作者： Meghna Julian Sebastian Shahanas KA Khan Joseph M Pappachan Mohammad sadiq Jeeyavudeen School of Life Sciences Keele UniversityStoke-on-Trent ST55BGUnited Kingdom Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom Department of Endocrinology and Metabolism University Hospitals of EdinburghEdinburgh EH164SAUnited Kingdom

Several epidemiological studies have clearly identified diabetes mellitus(DM)as a major risk factor for cognitive dysfunction,and it is going to be a major public health issue in the coming years because of the alarming rise in diabetes prevalence across the *** and neural tissues predominantly depend on glucose as energy substrate and hence,any alterations in carbohydrate metabolism can directly impact on cerebral functional output including cognition,executive capacity,and *** affects neuronal function and mental capacity in several ways,some of which include hypoperfusion of the brain tissues from cerebrovascular disease,diabetes-related alterations of glucose transporters causing abnormalities in neuronal glucose uptake and metabolism,local hyper-and hypometabolism of brain areas from insulin resistance,and recurrent hypoglycemic episodes inherent to pharmacotherapy of diabetes resulting in neuronal *** decline can further worsen diabetes care as DM is a disease largely self-managed by ***,it is crucial to understand the pathobiology of cognitive dysfunction in relation to DM and its management for optimal long-term care plan for patients.A thorough appraisal of normal metabolic characteristics of the brain,how alterations in neural metabolism affects cognition,the diagnostic algorithm for patients with diabetes and dementia,and the management and prognosis of patients when they have this dangerous combination of illnesses is imperative in this *** evidence-based narrative with the backup of latest clinical trial reviews elaborates the current understanding on diabetes and cognitive function to empower physicians to manage their patients in day-to-day clinical practice.

关键词： Diabetes mellitus dementia Cognitive function Antidiabetic medications Hyperglycemia Hypoglycemia

Impact of the metabolic syndrome on the evolution of neurodegenerative diseases

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Neural Regeneration Research 2021年第4期16卷 688-689页

作者： Ana Paula de A.Boleti Jeeser Alves Almeida Ludovico Migliolo S-InovaBiotech Programa de Pós-Graduação em BiotecnologiaUniversidade Católica Dom BoscoCampo GrandeMSBrazil Programa de Pós-Graduação em Ciências do Movimento Programa de Pós-Graduação em Saúde e Desenvolvimento na Região Centro OesteUniversidade Federal de Mato Grosso do SulCampo GrandeMSBrazil Programa de Pós-graduação em Biologia Celular e Molecular Programa de Pós-graduação em BioquímicaUniversidade Federal do Rio Grande do NorteNatalBrazil

Metabolic syndrome(MetS)might be defined as the simultaneous accumulation of s everal functional changes that frequently occur in adults over 60 years of age(Gomez et al.,2018).The diagnosis of MetS requires the presence of three or more factors such as high body mass,type-2 diabetes mellitus(T2DM),dyslipidemia,and arterial hypertension,which increase the risk of cardiovascular diseases as well as neurological complications,as stroke and dementia(Dyken and Lacoste,2018).Usually,these functional changes coincide and result in insensitivity for example hormones as leptin,adiponectin,and insulin(Dyken and Lacoste,2018).

关键词： diagnosis arterial hypertension

Chromosomal Alterations in Patients with Alzheimer Disease in Manaus,Amazonas,Brazil

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Journal of Pharmacy and Pharmacology 2019年第8期7卷 451-458页

作者： Cleiton Fantin Kledson Moraes Nunes Ernanda Raquel de Queirós Goncalves de Sousa e Fernandes Diana Vieira Brito Natalia Dayane Moura Carvalho Denise Corrêa Benzaquem Laboratório de Citogenética Escola Superior de Ciências da SaúdeUniversidade do Estado do AmazonasManausAmazonas 69065-001Brazil Laboratório de Análises Clínicas do Hospital Universitário Getúlio Vargas–HUGV ManausAmazonas 69020-170Brasil Secretaria Municipal de saúde SEMSAManausAmazonas 69057-000Brasil

Alzheimer disease(AD)is a complex neurodegenerative pathology that is characterized by a cognitive *** causes and mechanisms are still largely *** has been suggested that both genetic and life exposure factors can contribute to AD *** are also evidences that chromosomal alterations can be related to this *** far,there is not a precise diagnosis for AD,which is given only after the exclusion of other dementia by clinical and neurological *** possible association of AD with chromosomal alterations and the easy access of classical cytogenetics analysis are important aspects to consider,given the difficulties in *** to the lack of similar studies in Brazil and the increasing number of AD cases in the state of Amazonas,the aim of this study was to investigate the presence of chromosomal alterations in patients diagnosed with AD in Manaus,Amazonas,*** blood lymphocytes of twelve patients and twelve healthy individuals with the same age were analyzed using conventional *** AD patients presented cells with autosomal aneuploidy,while no chromosomal alterations were found in the age-matched ***,rare events of double and multiple aneuploidies are being reported in association with AD for the first *** results corroborate that the increase in the frequencies of aneuploidies is not related to the aging process itself,but it might be associated to the disease ***,no chromosomes were preferentially affected in all AD patients,and no consistent karyotype pattern for AD lymphocytes was ***,our results do not support the use of standard cytogenetics as a tool for AD *** studies are necessary to understand better the association between chromosomal alterations and AD.

关键词： AD karyotyping numeric chromosomal alterations double aneuploidies multiple aneuploidies