1,720,978 research outputs found
La verità sostenibile nelle malattie neurologiche degenerative
No full textLa comunicazione della diagnosi costituisce uno dei più importanti passi della presa in carico della persona affetta da demenza.
In questo lavoro si passano in disamina i dilemmi etici che interessano la comunicazione della diagnosi nel rispetto del principio di autonomia del paziente versus il principio di non maleficienza.
Infine vengono affrontati i problemi di natura giuridica, in particolare il consenso informato alla luce della consapevolezza che il paziente ha del proprio deficit cognitivo
Demenze e pseudodemenze.
No full textIl capitolo illustra il tema del deterioramento cognitivo su base degenerativa e quello secondario ad altre patologie neurologiche. L'autore si sofferma in particolare sulla malattia di Alzheimer illustrando gli aspetti clinici, diagnostici e prognostici
The evaluation of capacity in dementia: ethical constraints and best practice. A systematic review
Full text linkThe progressive ageing of a population leads to an increase in the number of people suffering from cognitive deterioration. This requires particular attention in terms of the necessity to assess these people's cognitive functions and their capacity to make decisions. The present systematic review analyses the clinical and ethical aspects of any assessment of capacity, with a specific focus on the capacity of the individual to give informed consent for medical treatment and also with regard to their testamentary capacity. The results indicate that the concepts of capacity, competence and decision-making need to be better clarified, ad-hoc devised tools are required and a multidisciplinary, clinical and legal approach to assessments of capacity needs to be adopted. This is crucial to guarantee that the two ethical principles of capacity assessment are adhered to: respect for an individual's autonomy and the protection of fragile individuals
Leukocyte telomere length in mild cognitive impairment and Alzheimer's disease patients
No full textNumerous studies have reported an association between shortened leukocyte telomere length (LTL) and increased risk of Alzheimer's disease (AD). In this study we investigated the relationship between LTL and AD development, including in the analysis patients with amnestic mild cognitive impairment (aMCI), a clinical entity considered prodromal of AD. LTL (T/S ratio) was measured in patients with AD (n = 61) or aMCI (n = 46), and compared with LTL of age-matched controls (n = 56). Significant LTL differences were observed between controls, aMCI and AD patients (p < 0.0001), with mean LTL values (± s.d) in the order: AD patients (0.70 ± 0.15) < aMCI patients (0.80 ± 0.14) < controls (0.88 ± 0.15). A positive relationship (linear regression p = 0.004) was observed between LTL and cognitive performance (measured by Mini Mental State Examination score). LTL did not differ by APOE genotype. The shortened LTL observed in AD patients appears to stem from progressive telomere erosion possibly correlated with the cognitive decline characterizing conversion from aMCI to AD. LTL reduction, indicating active cell proliferation, may reflect immune system involvement in AD pathogenesis
P21 gene variation and late-onset Alzheimer's disease in the Italian population.
No full textBackground: Variation at the cyclin-dependent kinase inhibitor gene P21 in a patient sample of the Italian population was investigated in search of genetic factors potentially involved in sporadic late-onset Alzheimer's disease (AD). Methods: Two single nucleotide polymorphisms (SNPs) were studied in this gene: a C>A transversion at codon 31 (ser>arg) in exon 2 (RS1801270) and a C>T transition occurring 20 bp downstream from the stop codon of exon 3 (RS1059234). Results: The odd ratios were: RS1801270 A allele = 0.62 (95% CI = 0.33-1.18; p = 0.14); RS1059234 T allele = 0.57 (95% CI = 0.33-0.98; p = 0.04). In addition, a longer duration of disease was found with genotypes carrying the RS1059234 T allele (4.3 +/- 2.5 years) than with those not carrying it (3.3 +/- 2.1 years) (p = 0.001). Conclusion: In the present sample, one of the two SNPs seems in some way related to AD, since carriers of one allele were slightly protected against AD onset. Copyright (C) 2013 S. Karger AG, Base
Influence of family history of dementia in the development and progression of late-onset Alzheimer's disease
No full textFamily history of dementia (FH) is a recognized risk factor for
developing late-onset Alzheimer’s disease (AD). We asked
whether having FH increases AD risk and influences disease
severity (age at onset and cognitive impairment) in 420 AD
patients and 109 controls with (FHþ) or without (FH). The
relationships of APOE and other AD risk genes with FH were
analyzed as well. The proportion of APOE e4 allele carriers was
higher among the FHþ than the FH AD patients (49.6% vs.
38.9%; P1⁄40.04). The distribution of the risk genotypes of nine
AD susceptibility genes previously examined (CHAT, CYP17,
CYP19, ESR1, FSHR, P53, P73, P21, PPARG) did not differ
between the FHþ and the FH AD patients, indicating that
none contributed significantly to familial clustering of disease.
FH was associated with an increased AD risk (odds ratio [OR]
2.71, 95% confidence interval [CI] 1.44–5.09; P1⁄40.002) independent
of carrying the APOE e4 allele (OR 2.61, 95%CI
1.53–4.44; P1⁄40.0004). Having a first-degree relative or a parent
with dementia was significantly associated with AD risk (OR 2.9,
95%CI 1.3–6.4; P1⁄40.009 and OR 2.7, 95%CI 1.1–6.2; P1⁄40.02)
but having a sibling with dementia was not (OR 1.7, 95%CI 0.2 to
14.7; P1⁄40.6). Among the FHþ AD patients, having one or both
parents affected seemed to raise the risk of earlier onset age
(P1⁄40.02) and greater cognitive impairment (P1⁄40.02) than
having only an affected sibling, whereas having two or more
affected relatives did not. 2015 Wiley Periodicals, Inc
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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