« DELIRIUM Delirium, a clinical syndrome characterized as an acute disorder of attention and cognitive function, is the most frequent complication of ...» Document abstract
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Language : english
medical studies
research papers
date published
26/11/2007
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SummaryDelirium, a clinical syndrome characterized as an acute disorder of attention and cognitive function, is the most frequent complication of hospitalization for elders and a potentially devastating problem. Delirium often is unrecognized despite sensitive methods for its detection, and its complications may be preventable.
Table of Contents
- Definitions
- Etiology
- Incidence and Prevalence
- Epidemiology
- Pathogenesis
- Clinical Manifestations
- Diagnosis and Evaluation
« 85. Delirium occurs in 5 to 10% of all persons age 65 and older, usually in the setting of acute illness and hospitalization. Severe ...» Document abstract
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Language : english
medical studies
research papers
date published
13/11/2007
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SummaryThe process of aging produces important physiologic changes in the central nervous system, including neuroanatomic, neurotransmitter, and neurophysiologic changes. These processes result in age-related symptoms and manifestations for many older persons. These physiologic changes develop at dramatically variable rates in different older persons, however, the decline being modified by factors such as diet, environment, lifestyle, genetic predisposition, disability, disease, and side effects of drugs. These changes can result in the common age-related symptoms of benign senescence, slowed reaction time, postural hypotension, vertigo or giddiness, presbyopia, presbycusis, stiffened gait, and sleep difficulties. In the absence of disease, these physiologic changes usually result in relatively modest symptoms and little restriction in activities of daily living. These changes decrease physiologic reserve, however, and increase the susceptibility to challenges posed by disease-related, pharmacologic, and environmental stressors.
Table of Contents
- Overview
- MENTAL STATUS EXAMINATION
- FUNCTIONAL ASSESSMENT
- Psychoactive Effects of Drugs in Older Patients
- ADVERSE DRUG EVENTS IN THE ELDERLY.
- DRUGS WITH PSYCHOACTIVE EFFECTS.
- PRINCIPLES OF DRUG THERAPY IN THE ELDERLY.
- Discussion
« In Robert Louis Jackson's 1981 book titled, The Art of Dostoevsky: Delirium and Nocturnes, he writes "Through spite, irrational will, and caprice, he [the ...» Document abstract
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Language : english
literature
school essay
date published
05/10/2007
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level : General public
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Summary“I am a sick man” are the opening words to Fyodor Dostoevsky’s novella Notes from Underground. For the narrator, the Underground Man is both figuratively and literally sick – his liver hurts but he will not receive treatment from doctors. Indeed, only a ‘sick man’ would choose to let his liver rot. Yet there is a strange philosophy embedded within the Underground Man’s words: through irrationality, spitefulness and arbitrariness he will pronounce his existence. His purpose for existence is his freewill.
Table of Contents
- After these words, the Underground Man goes into a sometimes funny and ironic and other times serious and sardonic tirade about how and why he has been living in the Underground for forty years.
- There are numerous ways of interpreting Notes from Underground.
- It is difficult to tell whether the Underground Man is joking or being serious.
- If the Underground Man were to choose against his best interest, one would think that it would affect him unpleasantly.
- As we have seen the Underground Man's entire purpose of existence is his right to choose.
- The Underground Man then alludes to Napoleon I and Napoleon III who led numerous battles, as well as, at the present time in the novella, the Civil War in the United States and the conflict between Prussia and Denmark.
- There are certain metaphors the Underground Man uses to describe Determinism.
- As we have seen the Underground Man's entire purpose of existence is his right to choose.
« However, CSF SRIF concentrations are also decreased in delirium, major depressive disorder, schizophrenia, multiple sclerosis, and dementia associated with ...» Document abstract
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Language : english
biology
research papers
date published
26/11/2007
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level : Advanced
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SummaryNeuropeptide receptors have undergone the same process of discovery and characterization that receptors for other neurotransmitters have enjoyed. The process begins with the pharmacological characterization of the receptor's physicochemical binding properties by assessing the affinity of various metabolically derived and synthetic peptide fragments, and the native molecule, for the receptor binding site found in membrane preparations. Peptide receptor locations are mapped with radioactive or fluorescent tags that are inserted into peptide molecules, which often contain substituted amino acids at the most vulnerable peptidase cleavage sites. Previously, once the peptide receptor was characterized pharmacologically, it was usually purified from some relatively enriched biological tissue source or brain region by affinity column chromatography. After it had been purified, binding parameters and activity were recharacterized for the reconstituted purified receptor protein and structural information obtained by X-ray crystallography. This process was closely followed in the purification of the neurotensin-neuromedin N receptor.
Table of Contents
- The neurotensin receptor was first characterized by photoaffinity labeling and cross-linking of radioiodinated ligands, which resulted in two labeled subunits of about 49 Kd and 51 Kd from rat brain synaptosomes.
- The much more powerful tools of molecular biology have been utilized more recently.
- Neuropeptide receptors have been associated with just about every type of second messenger signal transduction system that has been identified.
- Peptides are degraded to smaller fragments, and eventually to single amino acids, by specific enzymes termed peptidases.
- The metabolism of TRH has been investigated fairly completely, principally because of the limited number of fragments that can be generated from a tripeptide.
- The peptides involved in neuroendocrine regulation have cell bodies residing in the hypothalamus that receive feedback from all levels of the endocrine axes.
- Regional differences in CRF receptor regulation by corticosterone have also been reported, which have been shown to partly result from differential glycosylation of the CRF receptor.
- Alzheimer's Disease Dementia of the Alzheimer's Type represents up to two thirds of the demented population encountered in clinical practice, and over half of the nursing home beds in the United States are currently occupied by such patients.
- The CRF-containing interneurons of the cortex are also consistently depleted in Alzheimer's disease. As with SRIF, subcortical areas containing CRF neurons may be spared, but unlike SRIF, CRF receptors are increased in number (up-regulated) with no change in affinity.
- Corticotropin-Releasing Factor After a search spanning nearly three decades, CRF was isolated and characterized in 1981 as a 41-amino acid peptide.
- A series of studies have demonstrated significant elevations of CRF concentrations in the CSF of drug-free patients with major depression or following suicide.
- Like many other neuropeptide transmitters, central administration of SRIF produces a variety of behavioral and physiological effects.
- Decreased neurotensin concentrations in CSF have been reported in several populations of patients with schizophrenia when compared to controls or patients with other psychiatric disorders.
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