Ancillary to decline in cognitive abilities, patients with Alzheimer’s disease (AD) frequently suffer from behavioural and psychological symptoms of dementia (BPSD). Hypothalamic polypeptides such as melanin-concentrating hormone (MCH) and hypocretin-1 (HCRT-1, orexin-A) are promoters of sleep-wake regulation and energy homeostasis and are found to impact on cognitive performance. To investigate the role of MCH and HCRT-1 in AD, cerebrospinal fluid (CSF) levels were measured in 33 patients with AD and 33 healthy subjects (HS) using a fluorescence immunoassay (FIA). A significant main effect of diagnosis (F(1,62) = 8.490, p<0.01) on MCH levels was found between AD (93.76±13.47 pg/mL) and HS (84.65±11.40 pg/mL). MCH correlated with T-tau (r = 0.47; p<0.01) and P-tau (r = 0.404; p<0.05) in the AD but not in the HS. CSF-MCH correlated negatively with MMSE scores in the AD (r = −0.362, p<0.05) and was increased in more severely affected patients (MMSE≤20) compared to HS (p<0.001) and BPSD-positive patients compared to HS (p<0.05). In CSF-HCRT-1, a significant main effect of sex (F(1,31) = 4.400, p<0.05) with elevated levels in females (90.93±17.37 pg/mL vs. 82.73±15.39 pg/mL) was found whereas diagnosis and the sex*diagnosis interaction were not significant. Elevated levels of MCH in patients suffering from AD and correlation with Tau and severity of cognitive impairment point towards an impact of MCH in AD. Gender differences of CSF-HCRT-1 controversially portend a previously reported gender dependence of HCRT-1-regulation. Histochemical and actigraphic explorations are warranted to further elucidate alterations of hypothalamic transmitter regulation in AD.
Dacryocystorhinostomy (DCR) is performed in patients with saccal or postsaccal lacrimal duct obstruction. Focusing on the endonasal approach, we compared success rates, clinical outcome, complications and patient satisfaction of endoscopic vs. non-endoscopic techniques in endonasal DCR. We analyzed the results of 173 patients who underwent an endonasal DCR either utilizing a non-endoscopic (Group I) or an endoscopic technique (Group II) between 2006 and 2011. Irrigation tests followed the first day and at least 3 months after surgery. Postoperative patients' satisfaction and the occurrence of symptoms were documented and evaluated in a follow-up questionnaire. The minor complication rates of both endonasal DCR techniques were similarly low (10%) without severe adverse events. The use of the endoscope prolonged the operating time significantly (28 ± 9 min Group I vs. 34 ± 14 min Group II, p = 0.003). The success rate was 90.2% in Group II compared to only 57.9% in Group I (p < 0.000). Further, we determined the absence of reflux during the irrigation test 1 day after surgery as a significant predictor for the later outcome (R = 1.598, p = 0.005). The follow-up questionnaire revealed a significant improvement in subjectively perceived symptoms by the surgical intervention for both endonasal techniques (p < 0.000). The endoscopically assisted DCR is a safe and successful endonasal technique for patients with saccal or postsaccal lacrimal duct obstructions. The use of the endoscope led to significant higher success rates compared to non-endoscopic techniques in our collective.
Early-onset (EOD) and late-onset depression (LOD) are associated with different neuropsychological syndromes and structural brain changes. In this article, neuroimaging studies examining structural brain changes in elderly depressed patients are reviewed. The presented findings support current assumptions that depression in the elderly generally is associated with volume reductions in brain structures, notably in the hippocampus and the orbitofrontal cortex (OFC). Concerning structural cerebral differences between EOD and LOD, the review yielded conflicting results—only for OFC, but not for amygdala or hippocampus, pronounced effects in LOD than in EOD can be assumed
Zusammenfassung. Bisherige Befunde in der Sozial- und Entwicklungspsychologie haben gezeigt, dass Kinder mit einem hohen Ablehnungsstatus ( Moreno, 1954 ) und aggressiven Verhaltensauffälligkeiten in höherem Maße als andere Kinder dazu neigen, mehrdeutiges Verhalten von Gleichaltrigen als feindselig zu interpretieren ( Dodge, 1980 ). Anhand der vorliegenden Studie mit N = 115 Kindergartenkindern wurde ein Verfahren (SAVE) für Kinder im Vorschulalter entwickelt, anhand dessen solche spezifischen Wahrnehmungsmuster bei negativen Ereignissen erfasst werden können. Darüber hinaus wurde dieses Verfahren validiert, indem wir zum einen soziometrische Daten und zum anderen Einschätzungen der Erzieherinnen hinsichtlich aggressiver Verhaltensauffälligkeiten der Kinder erhoben haben. Die Ergebnisse bestätigen in Übereinstimmung mit unseren Hypothesen, dass Kinder, die bei negativen Ereignissen anderen Personen eher hohe Verantwortlichkeit zuschrieben, stärkeren Ärger empfanden und in diesen Situationen mit höherer Wahrscheinlichkeit aggressiv reagierten. Weiterhin wurden diese Kinder in erhöhtem Maße von Gleichaltrigen abgelehnt. Die Ergebnisse werden im Hinblick auf die zukünftige Anwendbarkeit des vorliegenden Verfahrens (SAVE) sowie mögliche Implikationen für die Praxis diskutiert.
Ancillary to decline in cognitive abilities, patients with Alzheimer's disease (AD) frequently suffer from behavioural and psychological symptoms of dementia (BPSD). Hypothalamic polypeptides such as melanin-concentrating hormone (MCH) and hypocretin-1 (HCRT-1, orexin-A) are promoters of sleep-wake regulation and energy homeostasis and are found to impact on cognitive performance. To investigate the role of MCH and HCRT-1 in AD, cerebrospinal fluid (CSF) levels were measured in 33 patients with AD and 33 healthy subjects (HS) using a fluorescence immunoassay (FIA). A significant main effect of diagnosis (F(1,62) = 8.490, p,0.01) on MCH levels was found between AD (93.76613.47 pg/mL) and HS (84.65611.40 pg/mL). MCH correlated with T-tau (r = 0.47; p,0.01) and P-tau (r = 0.404; p,0.05) in the AD but not in the HS. CSF-MCH correlated negatively with MMSE scores in the AD (r = 20.362, p,0.05) and was increased in more severely affected patients (MMSE #20 ) compared to HS (p,0.001) and BPSD-positive patients compared to HS (p,0.05). In CSF-HCRT-1, a significant main effect of sex (F(1,31) = 4.400, p,0.05) with elevated levels in females (90.93617.37 pg/mL vs. 82.73615.39 pg/mL) was found whereas diagnosis and the sex*diagnosis interaction were not significant. Elevated levels of MCH in patients suffering from AD and correlation with Tau and severity of cognitive impairment point towards an impact of MCH in AD. Gender differences of CSF-HCRT-1 controversially portend a previously reported gender dependence of HCRT-1-regulation. Histochemical and actigraphic explorations are warranted to further elucidate alterations of hypothalamic transmitter regulation in AD.
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