APOE genotype predicts AD and other dementia but not ischemic cerebrovascular disease.

BACKGROUND: The APOE polymorphism is an important modulator of plasma lipoproteins and a risk factor for AD. The hypothesis that APOE genotype, through its effect on lipoproteins, is a common risk factor for ischemic cerebrovascular disease (ICVD), AD, and other dementia (OD) was tested. METHODS: The authors genotyped 9241 individuals from the general population, 452 patients with ICVD and > or = 50% stenosis of the carotid arteries, and 75 patients with ICVD before the age of 50 years. Among the individuals from the general population, 211 had ICVD, 26 had AD, and 28 had OD. RESULTS: The APOE polymorphism was not associated with ICVD in any of the three patient groups. In contrast, the epsilon43 and epsilon44 genotypes were associated with 3- and 10-fold risks of AD (95% CI = 1.4 to 8.0 and 2.5 to 41.0), and the epsilon43 genotype was also associated with a 2.5-fold risk of OD (95% CI = 1.1 to 5.5). These increases in risk were not abolished by adjustment for lipids and lipoproteins. The fraction of AD that could be attributed to the epsilon43 and epsilon44 genotypes was 37 and 20% in the general population, whereas the fraction of OD that could be attributed to the epsilon43 genotype was 26%. CONCLUSION: The APOE polymorphism is a risk factor for AD and OD independent of lipid and lipoprotein levels but does not affect the risk of ICVD.

Evaluation of plasma von Willebrand factor as a biomarker for acute arterial damage in rats.

Plasma von Willebrand factor (vWF) was evaluated as a potential biomarker of acute arterial damage in rats after a vasotoxic dose of the dopaminergic vasodilator, fenoldopam (FP). Male Sprague-Dawley rats were given FP or isotonic saline by subcutaneous injection, and plasma vWF was measured at 2, 6, and 24 hours after challenge. Mean plasma vWF values increased in FP-treated rats compared to controls at 2 hours (167 vs 122%; p < 0.05) and 6 hours postdose (172 vs 130%; p < 0.01) but were comparable to control values after 24 hours. Mesenteric arterial lesions were observed microscopically in all FP-treated rats 24 hours postdose but were not present in rats at 1, 2, 4, 6, or 8 hours after FP challenge. Further, plasma vWF concentrations increased in saline-treated rats after only the minimal perturbation of repeated venipuncture. These results indicate an early, minimal, and transient release of vWF that precedes the onset of morphologically evident vascular damage. The minimal increases in plasma vWF concentrations were of limited predictive value, may be more reflective of an acute-phase reactant response, and were not considered a reliable biomarker of acute FP-induced arterial damage in the rat.

Evaluation of total serum bile acids concentration and bile acid profiles in healthy cats after oral administration of ursodeoxycholic acid.

Ursodeoxycholic acid (UDCA; 10 mg/kg of body weight) was administered orally to 5 healthy cats for 3 months. Signs of illness were not apparent in any cat during treatment with UDCA. Results of monthly CBC, serum biochemical analysis, and urinalysis were unchanged during drug administration. There was a decrease in serum cholesterol concentration in 4 cats. Total postprandial serum bile acids (PPSBA) concentration was significantly (P = 0.0003) increased over total preprandial serum bile acids (PRSBA) concentration at all sample collection periods. The PRSBA and PPSBA concentrations were significantly (P < 0.05) increased at all sample collection periods after administration of UDCA, compared with baseline values. Ursodeoxycholic and tauroursodeoxycholic acids were not detected in serum prior to initiating administration of UDCA. Both bile acids were detected in the serum of all cats 1 and 2 months after UDCA administration and were detected in the serum of 2 cats 3 months after initiating UCDA administration. Hepatic ultrasonographic findings were normal before and after completion of UDCA administration. A mild, focal lymphocytic infiltrate was observed in 3 cats 3 months after initiating UDCA administration. Results of the study indicate that UDCA is absorbed into the systemic circulation of cats after oral administration, undergoes hepatic conjugation, and appears to be safe.

[The first experiences from a dementia-unit at a geriatric department]. / De første erfaringer fra et demensafsnit på en geriatrisk afdeling.

Traditionally, patients suffering from dementia are treated in psychiatric wards. In many geriatric patients, confusion/dementia is one of several problems prohibiting an early return to the previous way of living. To provide the best treatment, one of our geriatric wards was used for these patients. Based on our experiences from the first 58 patients discharged during the period 09.11.89-31.01.91, it was possible to create and secure a stable environment, with suitable activities for the satisfaction of the patients, their families and the staff. A structured procedure, including rating scales, was a great help in disclosing the patients' problems. One quarter of the patients were not demented, but temporarily confused due to other reasons. One third of the demented patients had no public assistance. It was necessary to discharge 60% of the demented and only 10% of the non-demented patients to nursing homes. Sheltered home-like living could be an alternative to the expensive nursing homes.