Serum cobalamin and methylmalonic acid in Alzheimer dementia.

The cobalamin status was evaluated in Alzheimer dementia (n = 26), other dementias (n = 24), various gerontopsychiatric disorders (n = 25), and in neuro-psychiatrically healthy controls (n = 20). Supplementing serum cobalamin we measured methylmalonic acid (MMA), a metabolite accumulating early in cobalamin deficiency. Subnormal cobalamin and/or clearly elevated MMA concentrations were found in 11 cases: 7 Alzheimer patients (27%), 2 with other dementias (8%), one psychiatric patient (4%), and one control (5%). None presented the typical neurologic features of cobalamin deficiency and macrocytosis was found in only one. The mean cobalamin concentration was significantly lower in Alzheimer patients (179 +/- 18 pmol/l) than in the age-matched controls (256 +/- 23 pmol/l) (p = 0.013) and the other patient groups. Correspondingly, the mean MMA level was higher in the Alzheimer group (0.480 +/- 0.062 mumol/l) than in any other diagnostic group (controls: 0.347 +/- 0.040 mumol/l). Comparing the Alzheimer group to the other groups as a whole, the elevation was significant (p = 0.0097). Our findings indicate that Alzheimer patients are particularly prone to cobalamin deficiency, and even subtle biochemical signs of deficiency seem to justify treatment.

[Complaints following treatment of common acute eye diseases]. / Gener efter behandling af almindeligt forekommende akutte øjenlidelser.

The aim of the study was to determine the duration of symptoms in patients treated in the emergency room at Glostrup Hospital for acute eye-trouble. Nine common diagnoses were selected for the study. All patients seen during a 2 1/2 month period were asked to complete a questionnaire one week after the consultation. Those who did not return the questionnaire, and cases where the diagnosis was changed by a doctor in the days following the consultation, were excluded. The final material comprised 422 patients. 28% did not have any complaints after the consultation. 50% were free of symptoms within 24 hours and 75% within 48 hours. 10% had symptoms for more than a week. Cases of infectious conjunctivitis and trauma to the eye (without intrabulbar lesion) had the highest risk of developing symptoms after the consultation. The lowest incidence of complaints was seen among patients in whom a foreign body was removed from the cornea or conjunctiva. The longest duration of symptoms was seen among patients with infectious conjunctivitis. Cases with a foreign body on the cornea or conjunctiva or trauma to the eye (without intrabulbar lesion) had a slightly longer duration of the symptoms when a corneal tear was present. Patients with photoelectric conjunctivitis and conjunctivitis caused by chemical products had the shortest durations of symptoms. Patients with pain should be treated with analgesic tablets as the pain-relief after application of local anaesthetics was brief. Only half of those who had a prescription for chloramphenicol used this for as long as it had been recommended. Compliance was better to ointment than to eye-drops.