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University School Of Medicine (university + school_of_medicine)
Selected AbstractsImproving Medical Student Attitudes Toward Older Patients Through a "Council of Elders" and Reflective Writing ExperienceJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2009Glenda R. Westmoreland MD In an effort to reduce "agism" which is prevalent among medical trainees, a new geriatrics educational experience for medical students aimed at improving attitudes toward older patients was developed. Each 90-minute Older Adult Session included four components: initial reflective writing exercise; introduction to the session; 75-minute dialogue with the "Council of Elders," a group of active, "well" older adults; and final reflective writing exercise. The new session was provided to 237 first- and second-year medical students during the 2006/07 academic year at Indiana University School of Medicine. Session evaluation included comparing scores on the 14-item Geriatrics Attitude Scale administered before and after the session, identifying attitude changes in the reflective writing exercises, and a student satisfaction survey. Student responses on the Geriatrics Attitude Scale after the session were significantly improved in seven of 14 items, demonstrating better attitudes toward being with and listening to older people and caring for older patients. Analysis of the reflective writings revealed changing of negative to positive or reinforced positive attitudes in 27% of medical students, with attitudes not discernable in the remaining 73% (except one student, in whom positive attitudes changed to negative). Learner satisfaction with the Older Adult Session was high, with 98% agreeing that the session had a positive effect on insight into the care of older adults. A Council of Elders coupled with a reflective writing exercise is a promising new approach to improving attitudes of medical students toward their geriatric patients. [source] How to Treat Hypertension in Patients With Coronary Heart Disease disease.JOURNAL OF CLINICAL HYPERTENSION, Issue 5 2008Marvin Moser MD Following a hypertension symposium in Los Angeles in October 2007, a panel was convened to discuss how to treat hypertension in patients with coronary artery disease or with evidence of multiple major risk factors for coronary heart disease. Marvin Moser, MD, Clinical Professor of Medicine at the Yale University School of Medicine, New Haven, CT, moderated the discussion. Jackson T. Wright Jr, MD, PhD, Professor of Medicine, Program Director of William T. Dahms Clinical Research, and Director of the Clinical Hypertension Program at Case Western Reserve University, Cleveland, OH; Ronald G. Victor, MD, Professor and Division Chief, Hypertension, University of Texas Southwestern Medical Center, Dallas, TX; and Joel Handler, MD, Hypertension Lead, Care Management Institute, Kaiser Permanente, Anaheim, CA, participated in the discussion. [source] Newer Combination Therapies in the Management of Hypertension: An UpdateJOURNAL OF CLINICAL HYPERTENSION, Issue 5 2008Alan H. Gradman MD A panel was convened to discuss current combination therapy for hypertension. Alan H. Gradman, MD, of the Western Pennsylvania Hospital, Temple University School of Medicine (Clinical Campus), Pittsburgh, PA, moderated the discussion. Participants included Matthew R. Weir, MD, University of Maryland School of Medicine, Baltimore, MD, and George L. Bakris, MD, University of Chicago, Chicago, IL. [source] Microalbuminuria, Chronic Renal Disease, and the Effects of the Metabolic Syndrome on Cardiovascular EventsJOURNAL OF CLINICAL HYPERTENSION, Issue 7 2007Marvin Moser MD In March 2007, a panel discussion was held following a hypertension symposium in New York, New York. The panel was moderated by Marvin Moser, MD, Clinical Professor of Medicine at the Yale University School of Medicine, New Haven, Connecticut. Serving on the panel were James R. Sowers, MD, Professor of Medicine and Physiology at the University of Missouri, Columbia, Missouri, and Henry R. Black, MD, Clinical Professor of Medicine at the New York University School of Medicine, New York, New York. This expert panel discussion was supported by Novartis and each author received an honorarium from Novartis for time and effort spent participating in the discussion and reviewing the transcript for important intellectual content prior to publication. The authors maintained full control of the discussion and the resulting content of this article; Novartis had no input in the choice of topic, speakers, or content. [source] The ALLHAT Study Revisited: Do Newer Data From This Trial and Others Indicate Changes in Treatment Guidelines?JOURNAL OF CLINICAL HYPERTENSION, Issue 5 2007Marvin Moser MD Following a hypertension symposium in Washington, DC, in November 2006, a panel was convened to discuss new data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) and to revisit the significance of this trial in the management of hypertension. Based on these data and information from other trials, the expert panel also addressed the questions, "Is it time for a new Joint National Committee report?" and "Should the 2003 hypertension treatment recommendations be updated or are they still valid?" The panel was moderated by Marvin Moser, MD, Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. On the panel were Suzanne Oparil, MD, Professor of Medicine at the University of Alabama in Birmingham, and President of the American Society of Hypertension (ASH); William Cushman, MD, Professor of Preventive Medicine and Medicine at the University of Tennessee in Memphis and attending physician at the Washington, DC, VA Medical Center; and Vasilios Papademetriou, MD, Professor of Medicine at Georgetown University in Washington, DC, and attending physician at the Washington, DC, VA Medical Center. This expert panel discussion was supported by Pfizer Inc and each author received an honorarium from Pfizer Inc for time and effort spent participating in the discussion and reviewing the transcript for important intellectual content prior to publication. The authors maintained full control of the discussion and the resulting content of this article; Pfizer had no input in the choice of topic, speakers, or content. (Please note that Dr Oparil's comments herein do not represent the official opinion of ASH.) [source] Cutaneous gene transfer for skin and systemic diseasesJOURNAL OF INTERNAL MEDICINE, Issue 1 2002P. A. KHAVARI This article is partially based on the findings presented at a symposium on Cutaneous Gene Therapy, held in Uppsala, September 2001, and abstracted in Acta Derm Venereol 81: 227,239. Abstract.,Khavari PA, Rollman O, Vahlquist A (Stanford University School of Medicine, Stanford, CA, USA; and Department of Medical Sciences, Dermatology, Uppsala University, Uppsala, Sweden). Cutaneous gene transfer for skin and systemic diseases (Review). J Intern Med 2002; 252: 1,10. Recent progress in molecular genetics has illuminated the basis for a wide variety of inherited and acquired diseases. Gene therapy offers an attractive therapeutic approach capitalizing upon these new mechanistic insights. The skin is a uniquely attractive tissue site for development of new genetic therapeutic approaches both for its accessibility as well as for the large number of diseases that are amenable in principle to cutaneous gene transfer. Amongst these opportunities are primary monogenic skin diseases, chronic wounds and systemic disorders characterized by low or absent levels of circulating polypeptides. For cutaneous gene therapy to be effective, however, significant progress is required in a number of domains. Recent advances in vector design, administration, immune modulation, and regulation of gene expression have brought the field much nearer to clinical utility. [source] Developing an optimal approach to global drug safetyJOURNAL OF INTERNAL MEDICINE, Issue 4 2001R. Balkrishnan Abstract.,Balkrishnan R, Furberg CD (Wake Forest University School of Medicine, Winston-Salem, NC, USA). Developing an optimal approach to global drug safety (Review). J Intern Med 2001: 250; 271,279. An increasing number of media reports on a number of marketed drugs withdrawn because of harmful effects, a scientific report on epidemic proportions of serious adverse drug reactions in hospitalized patients, and a disturbing report on medical mistakes that includes medication errors have recently all brought drug safety into intense focus and placed it under greater scrutiny. Concerted efforts are now being made to understand the causes of drug safety problems and to find ways to reduce their frequency. An international symposium, ,Developing an Optimal Approach to Drug Safety' was held at Wake Forest University in the Fall of 2000 to identify the issues and solutions to extant problems in this area. This report summarizes the resulting discussions of global postmarketing surveillance initiatives and describes efforts to reduce medication errors, and improve global communication about drug safety. [source] A case of POEMS syndrome with high concentrations of interleukin-6 in pericardial fluidJOURNAL OF INTERNAL MEDICINE, Issue 2 2001N. Shikama Abstract. Shikama N, Isono A, Otsuka Y, Terano T, Hirai A (Department of Internal Medicine, Chiba Municipal Hospital; and Second Department of Internal Medicine, Chiba University School of Medicine, Chiba, Japan). A case of POEMS syndrome with high concentrations of interleukin-6 in pericardial fluid. J Intern Med 2001; 250: 170,173. The POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy of various forms, monoclonal gammopathy, skin changes) is a rare multisystem disorder of unknown pathogenesis. Overexpression of proinflammatory cytokines has been implicated in the pathogenesis of POEMS syndrome, however, it is not known whether there is an association between abnormalities in cytokines and pericardial fluid. We present a case of POEMS syndrome with high concentrations of interleukin-6 (IL-6) in pericardial fluid. In our patient, pericarditis developed into cardiac tamponade, and the concentration of IL-6 in pericardial fluid was remarkably elevated compared with that in serum (1760 vs. 6.57 pg mL,1). We suggest that IL-6 is associated with the progression or maintenance of pericarditis as a result of POEMS syndrome. [source] Advanced glycation end product in familial amyloidotic polyneuropathy (FAP)JOURNAL OF INTERNAL MEDICINE, Issue 4 2000N. Nyhlin Abstract. Nyhlin N, Ando Y, Nagai R, Suhr O, El Sahly M, Terazaki H, Yamashita T, Ando M, Horiuchi S (Umeå University Hospital, Umeå, Sweden and Kumamoto University School of Medicine, Kumamoto, Japan). Advanced glycation end product in familial amyloidotic polyneuropathy (FAP). J Intern Med 2000; 247: 485,492. Objectives. Advanced glycation end products (AGE) are present in amyloid deposits in ,2 -microglobulin amyloidosis, and it has been postulated that glycation of ,2 -microglobulin may be involved in fibril formation. The aim of this paper was to ascertain whether AGE occur in amyloid deposits in familial amyloidotic polyneuropathy (FAP). Setting. Department of Medicine, Umeå University Hospital and First Department of Internal Medicine, Kumamoto University School of Medicine. Design. The presence of AGE was sought immunohistochemically and biochemically in amyloid-rich tissues from patients with FAP. Subjects. Biopsy specimens from nine patients and 10 controls were used for the immunohistochemical analysis. For amyloid preparation, vitreous samples from three FAP patients were used. Results. Immunohistochemical studies using a polyclonal anti-AGE antibody revealed positive immunoreactivity in intestinal materials, but the pattern of reactivity was unevenly distributed; it was often present in the border of amyloid deposits, or surrounding them. Non-amyloid associated immunoreactivity was also observed in a few regions of the specimens, although the AGE-positive structures were situated in areas containing amyloid deposits. Western blotting of purified amyloid from the vitreous body of FAP patients revealed a significant association of AGE with amyloid fibrils. Conclusion. The immunoreactivity for the AGE antibody suggests that AGE may be involved in fibril formation in FAP. [source] Academic misconduct among medical students in a post-communist countryMEDICAL EDUCATION, Issue 3 2004Maja Hrabak Aim, To assess the prevalence of, attitudes towards and willingness to report different forms of academic dishonesty among medical students in a post-communist transitional country. Methods, An anonymous, self-administered questionnaire was distributed to medical students in Years 2,6 at the Zagreb University School of Medicine; 827 (70%) valid questionnaires were returned and analysed. Results, Most of the students (94%) admitted cheating at least once during their studies. The most frequent type of misconduct was ,signing in an absent student on a class attendance list' (89.1%), and the least frequent ,paying for passing an examination' (0.7%). The number of committed types of misconduct out of 11 listed types increased from Year 2 (median 2) to Year 6 (median 4). Cheating behaviours could be clustered into 4 groups based on self-reported cheating, perceived prevalence of cheating, attitude towards cheating, and willingness to report cheating. The clustered behaviours that most students admitted to were perceived as the most frequent, more approved of and less likely to be reported. The strongest predictors of dishonest behaviour were attitude, perception of peer group behaviour and study year. Almost half (44%) the students said they would never report any form of cheating. Conclusion, Academic misconduct is widespread among medical students at the largest medical school in Croatia and its prevalence is greater than that reported for developed countries. This may be related to social and cultural factors specific to a country in the midst of a post-communist transition to a market economy, and calls for measures to be instigated at an institutional level to educate against and prevent such behaviour. [source] Successful teaching in evidence-based medicineMEDICAL EDUCATION, Issue 1 2000William A Ghali Objectives Several published articles have described the importance of exposing medical trainees to the ,new paradigm' of evidence-based medicine (EBM). Recognizing this, we sought to develop and objectively evaluate a mini-course in EBM for third-year medical students. Design We developed a mini-course consisting of four sessions in which students learn to derive sequentially focused questions, search MEDLINE, review articles critically and apply information from the literature to specific clinical questions. To evaluate the teaching intervention, we performed a controlled educational study. Students at the intervention site (n=34) attended the EBM mini-course, while students at the control site (n=26) received more ,traditional' didactic teaching on various clinical topics. Intervention and control students were surveyed immediately before and after the mini-course to assess changes in reading and literature searching skills, as well as a tendency to use the literature to answer clinical questions. Setting Boston University School of Medicine. Subjects Third-year medical students. Results The intervention was associated with significant changes in students' self-assessed skills and attitudes. MEDLINE and critical appraisal skills increased significantly in the intervention group relative to the control group (significance of between group differences: P=0·002 for MEDLINE and P=0·0002 for critical appraisal), as did students' tendency to use MEDLINE and original research articles to solve clinical problems (significance of between group differences: P=0·002 and P=0·0008, respectively). Conclusions We conclude that this brief teaching intervention in EBM has had a positive impact on student skills and attitudes at our medical school. We believe that the key elements of this intervention are (1) active student involvement, (2), clinical relevance of exercises and (3) integrated teaching targeting each of the component skills of EBM. [source] Family Caregiver Research: Multidisciplinary Approaches to Reduce Family StressNURSING & HEALTH SCIENCES, Issue 2 2000Sharon K. Ostwald 28,29 March 2000 Yamaguchi University School of Medicine, Ube, Japan (Local Organizers: Junko Yoneda and Susumu Tomonaga, Yamaguchi University) [source] Factors Affected the Adjustment of Elders in the Health Promotion Center of the Elders at Boromarajonani College of Nursing BuddhachinarajNURSING & HEALTH SCIENCES, Issue 2 2000Panchit Kraungkumhang 28,29 March 2000 Yamaguchi University School of Medicine, Ube, Japan (Local Organizers: Junko Yoneda and Susumu Tomonaga, Yamaguchi University) [source] An Ethnomethodologic Analysis of Accounts of Feeding Elders in Long-term CareNURSING & HEALTH SCIENCES, Issue 2 2000Charon A. Pierson 28,29 March 2000 Yamaguchi University School of Medicine, Ube, Japan (Local Organizers: Junko Yoneda and Susumu Tomonaga, Yamaguchi University) [source] Improving Quality of Life for Elders: Resident Satisfaction with Nursing HomeNURSING & HEALTH SCIENCES, Issue 2 2000Heeyoung Lee Oh 28,29 March 2000 Yamaguchi University School of Medicine, Ube, Japan (Local Organizers: Junko Yoneda and Susumu Tomonaga, Yamaguchi University) [source] Intravenous Administration of Class I Antiarrhythmic Drug Induced T Wave Alternans in an Asymptomatic Brugada Syndrome PatientPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2003KIMIE OHKUBO A 53-year-old man with an abnormal ECG was referred to the Nihon University School of Medicine. The 12-lead ECG showed right bundle branch block and saddleback-type ST elevation in leads V1,V3 (Brugada-type ECG). Signal-averaged ECG showed positive late potentials. Double ventricular extrastimuli (S1: 500 ms, S2: 250 ms, S3: 210 ms) induced VF. Amiodarone (200 mg/day) was administered for 6 months and programmed ventricular stimulation was repeated. VF was induced again by double ventricular stimuli (S1: 600 ms, S2: 240 ms, S3: 170 ms). Intravenous administration of class Ic antiarrhythmic drug, pilsicainide (1 mg/kg), augmented ST-T elevation in leads V1,V3, and visible ST-T alternans that was enhanced by atrial pacing was observed in leads V2 and V3. Visible ST-T wave alternans disappeared in 15 minutes. However, microvolt T wave alternans was present during atrial pacing at a rate of 70/min without visible ST-T alternans. (PACE 2003; 26:1900,1903) [source] Congenital lobar emphysema: Differential diagnosis and therapeutic approachPEDIATRICS INTERNATIONAL, Issue 5 2008Refik Ulku Abstract Background: Congenital lobar emphysema (CLE) is a rare anomaly of lung development that usually presents in the neonatal period with respirator distress and pulmonary lobar hyperinflation. It is commonly confused with pneumothorax. The aim of the present paper was to review the authors' experience in order to emphasize the importance of differential diagnosis with pneumothorax. Methods: Children with CLE treatment at Department of Thoracic Surgery, Dicle University School of Medicine, Turkey, between January 1993 and June 2004, were reviewed. Results: Ten children consisting of six boys and four girls (age range, 6 h,12 months) had CLE. Major presenting symptoms were tachypnea(n = 100%) and respiratory distress in (n = 80%). On chest radiograph, emphysema was seen in all patients, and shift-herniation to the opposite lung, atelectasis were observed. Computed tomography was performed in all patients, which indicated emphysema in the affected lobes in all cases. Pulmonary perfusion scan was performed in two patients, showing loss of perfusion in the affected lobe. The most common affected lobe was the left upper lobe (50%). In the present series, three patients were mistakenly diagnosed as pneumothorax and intercostal drains were inserted in the emergency department. Eight patients underwent lobectomy, and postoperative course was uneventful. Two patients were followed conservatively. Emphysema was detected in all pathological specimens. One patient was lost to follow up. Mean follow-up duration of all patients was 26.8 ± 29.24 months (range, 1,89 months). Conclusions: CLE is established on combined clinical, radiological and scintigraphic imaging. Surgical excision of the affected lobe is the appropriate treatment. Particularly, differential diagnosis should be made between CLE and pneumothorax. [source] What I learnt from studying epilepsy: Epileptology and myselfPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2004HARUO AKIMOTO Abstract, My life work with epilepsy has allowed me to learn a great deal. As an old soldier, I would like to give an account of some important milestones in my lifetime learning. The first factor that linked me to epilepsy was listening to a lecture delivered by Dr Yushi Uchimura on ,The pathogenesis of Ammon's horn sclerosis' at a conference of the Japanese Society of Neurology (now Japanese Society of Psychiatry and Neurology) in 1928 when I was a 4th year medical student at Tokyo University. The following year, I started to study under Dr Uchimura at the Department of Psychiatry, Hokkaido University School of Medicine. Another factor that linked me to clinical care and research of epilepsy as a psychiatrist was my encounter with the two volumes of ,Selected Writing of John Hughlings Jackson' edited by J. Taylor. Jackson's greatest asset and contribution to modern epileptology include (i) the discovery of ,Jacksonian epilepsy', (ii) ,conceptual revolution of epilepsy' by recognizing transient mental disorders as seizures, (iii) modern definition of epilepsy by defining epileptic seizures as discharges in the gray matter, and (iv) discovery of ,new epilepsy' (now temporal lobe epilepsy). In 1940, I reported clinical courses indistinguishable from schizophrenia in epilepsy cases. Through my studies, I disputed the then prevailing interpretation of this condition as epilepsy complicating schizophrenia, and proved that these cases were in fact epileptic mental disorders caused by epilepsy. Many patients with epilepsy require medical care as well as rehabilitation and welfare support. We need to further promote the facilities for rehabilitation and employment in the community for persons with epilepsy, such as co-operatives and welfare worksites. The issues that epileptology and epilepsy face in the 21st century is to realize the goals of liberating epilepsy from social stigma and protecting all the citizen's rights for persons with epilepsy. [source] The Proceedings of the 17th Annual Meeting of Adolescent Psychiatry, 17 November 1999, Fukushima Medical University School of Medicine, JapanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2003Article first published online: 23 SEP 200 First page of article [source] Management of Stage IV Glottic Carcinoma: Therapeutic OutcomesTHE LARYNGOSCOPE, Issue 8 2004Gershon J. Spector MD Abstract Objectives/Hypothesis: The best therapeutic approach for the treatment of stage IV glottic carcinoma is controversial. Study Design: A retrospective study. Methods: A retrospective study of Tumor Research Project data was performed using patients with stage IV glottic squamous cell carcinoma treated with curative intent by five different treatment modalities from 1955 to 1998 at Washington University School of Medicine and Barnes-Jewish Hospital (St. Louis, MO). Results: Ninety-six patients with stage IV glottic carcinoma were treated by five modalities: total laryngectomy (TL) (n = 13), total laryngectomy with neck dissection (TL/ND) (n = 18), radiation therapy alone (RT) (n = 7) (median dose, 69.5 Gy), total laryngectomy combined with radiation therapy (TL/RT) (n = 10), and total laryngectomy and neck dissection combined with radiation therapy (TL/ND/RT) (n = 48). The overall 5-year observed survival (OS) rate was 39%, and the 5-year disease-specific survival (DSS) rate was 45%. The 5-year DSS rates for the individual treatment modalities included the following: TL, 58.3%; TL/ND, 42.9%; RT, 50.0%; TL/RT, 30.0%; and TL/ND/RT, 43.9%. There was no significant difference in DSS for any individual treatment modality (P = .759). The overall locoregional control rate was 69% (66 of 96). The overall recurrence rate was 39% with recurrence at the primary site and in the neck at 19% and 17%, respectively. Recurrence was not related to treatment modality. The 5-year DSS after treatment of locally recurrent cancer (salvage rate) was 30% (3 of 10) and for recurrent neck disease (28 of 67) was 42%. The incidence of delayed regional metastases was 28%; of distant metastasis, 12%; and of second primary cancers, 9%. There was no statistically significant difference in survival between node-negative (N0) necks initially treated (5-y DSS, 31%) versus N0 necks observed and later treated if necessary (5-y DSS, 44%) (P = .685). Conclusion: The five treatment modalities had statistically similar survival, recurrence, and complication rates. The overall 5-year DSS for patients with stage IV glottic carcinoma was 45%, and the OS was 39%. The cumulative disease-specific survival (CDSS) was 0.4770 with a mean survival of 10.1 years and a median survival of 3.9 years. Patients younger than age 55 years had better survival (DSS) than patients 56 years of age or older (P = .0002). Patients with early T stage had better survival than patients with more advanced T stage (P = .04). Tumor recurrence at the primary site (P = .0001) and in the neck (P = .014) and distant metastasis (P = .0001) had a deleterious effect on survival. Tumor recurrence was not related to treatment modality. Patients with clear margins of resection had a statistically significant improved survival (DSS and CDSS) compared with patients with close or involved margins (P = .0001). Post-treatment quality of life was not significantly related to treatment modality. Patients whose N0 neck was treated with observation and appropriate treatment for subsequent neck disease had statistically similar survival compared with patients whose N0 neck was treated prophylactically at the time of treatment of the primary. A minimum of 7 years of follow-up is recommended for early identification of recurrent disease, second primary tumors, and distant metastasis. None of the standard treatment modalities currently employed has a statistical advantage regarding survival, recurrence, complications, or quality of life. [source] The ED of the Future: an Interdisciplinary Graduate Course in Healthcare DesignACADEMIC EMERGENCY MEDICINE, Issue 2009David Cowan Six faculty members from Georgia Institute of Technology, Emory University School of Medicine, Emory Healthcare, and Perkins + Will created and taught a one-semester course titled "The Emergency Department of the Future". The goals of the course were to provide an environment for students to be exposed to the unique challenges of healthcare design, to experience and learn techniques for successful interdisciplinary design, and to create innovations with impact. Twenty graduate students representing five disciplines (architecture, health systems, human-computer interaction, computer science, and systems engineering) participated in this class. The course included a series of didactic lectures covering a wide range of issues including architectural design of hospitals and emergency departments, observation techniques for working environments, electronic medical records, and patient-centered care. Lecturers included emergency physicians, nurses, architects, human-computer interaction researchers, and design specialists. Students developed problem statements along with prototype design solutions through these lectures, direct observation, and interaction with course faculty. The resulting projects include a mobile triage chair that takes vital signs, equipment sliders for easy functional transformation, an integrated lighting design, as well as patient assistants for self registration, communication, environmental control, and discharge support. The developed projects have generated ideas to improve emergency care that may be implementable commercial products as well as fundable projects for future research. The final presentation open house attracted over a hundred visitors from local and national healthcare facilities and industry. This presentation will highlight the structure and organization of the course as well as the resulting projects. [source] Cognitive effects of memantine in postmenopausal women at risk of dementia: a pilot studyACTA NEUROLOGICA SCANDINAVICA, Issue 3 2009T. E. Wroolie Background,,, To determine the effects of memantine on cognition in a normal population of postmenopausal women with putative risk factors for Alzheimer's disease (AD) using a built-in control for the genetic risk factor for AD (apoE-,4 status). Methods,,, A prospective, open-label, 6-month pilot medication trial with memantine and follow-up after discontinuance conducted at the Center for Neuroscience in Women's Health, Stanford University School of Medicine. Neuropsychological data were collected on 22 community-dwelling postmenopausal women (11 apoE-,4 carriers and 11 apoE-,4 non-carriers) with at least one putative risk factor for AD. Results,,, ApoE-,4 status was not a significant predictor of change in neuropsychological performance. Changes associated with memantine treatment for entire sample included significant declines in some variables associated with verbal learning and memory that improved upon medication withdrawal. A positive medication effect was noted with executive functions and possibly category fluency. Trend-level improvements were seen in motor dexterity of the non-dominant hand and maintained even after drug discontinuance. Conclusions,,, Treatment with memantine appeared to have differential effects on cognitive performance in a population of women with putative risk factors for AD. ApoE-,4 carrier status did not account for observed changes in cognition. [source] | ||||||||||