Effect of tetrahydroaminoacridine on cognition, function and behaviour in Alzheimer's disease.

Objective: To determine the efficacy of tetrahydroaminoacridine (THA) in Alzheimer's disease.

Design: Randomized, double-blind, multiple crossover trial with three treatment periods, each consisting of 3 weeks of active drug therapy and 3 weeks of placebo administration.

Setting: Referral-based geriatric practice in a community hospital.

Reliability of a Standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination.

Objective: The objective of this study was to compare the reliability of the Mini-Mental State Examination with that of a new Standardized Mini-Mental State Examination, which has expanded guidelines for administration and scoring.

Method: The subjects were 32 stable elderly residents of a nursing home and 16 elderly residents of a chronic care hospital unit. Six raters administered the Folstein Mini-Mental State to 22 of these stable elderly subjects, and five raters administered the standardized version to 26 of these subjects.

Multiple-sited (heterotopic) pregnancy after in vitro fertilization and gamete intrafallopian transfer.

Pregnancies occurring simultaneously in different body sites (heterotopic pregnancies) are a rare condition thought to occur in 1 of 30,000 spontaneous pregnancies. Individual cases may occur after in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT). In the past 4 1/2 years, our unit has performed 6,204 IVF/GIFT or pronuclear stage transfer cycles of treatment.

Patient age and success in a human IVF programme.

Previous studies suggest that at around 40 years of age, pregnancy rates achieved by IVF programmes fall and pregnancy loss rates increase. The actual age at which this occurs has not been clearly delineated. This study of 2,692 patients including 94 aged 41 or over shows that satisfactory pregnancy rates can be achieved up to and including age 40.

The cardiopulmonary and renal hemodynamic effects of norepinephrine in canine pulmonary embolism.

Autologous blood clot was injected into six dogs to produce a graduated decrease in cardiac output (CO). The effects of an infusion of norepinephrine, titrated to specific end points, were recorded before embolization and at two levels of pulmonary hypertension. Simultaneous measurements of systemic and renal hemodynamics were made.

Acute effects of oral pyridostigmine on memory and cognitive function in SDAT.

This study reports the effects of the anticholinesterase pyridostigmine on cognitive function in 15 elderly patients with senile dementia of the Alzheimer type (SDAT). Each patient was given placebo and pyridostigime 60 mg orally four times over 26 hours, with a seven day washout between, using a randomized double-blind cross-over design. There was no significant improvement in cognitive function following placebo or pyridostigmine.

The effects of a three-month exercise programme on neuropsychological function in elderly institutionalized women: a randomized controlled trial.

This randomized controlled trial examined the effect of a 3-month exercise programme on neuropsychological function in a population of very elderly institutionalized women. Baseline neuropsychological testing was performed, and following 3 months of exercise or control intervention, subjects were retested 3-7 days after the completion of the study period. Apart from the Word Fluency Test, there was no significant improvement in any of the neuropsychological test scores.

Acute chest pain in an elderly woman.

A 79-year-old woman was admitted to hospital complaining of chest pain, increasing weakness, anorexia, hoarseness, headache and discomfort in the throat and jaws while eating. Physical examination, chest x-rays, serial electrocardiograms and cardiac enzymes were unremarkable. After admission she developed weakness and numbness in the left leg with urinary retention, decreased sensation to touch, weakness, increased tone, absent deep tendon reflexes and a positive Babinski sign on the left.

Acute effects of exercise on neuropsychological function in elderly subjects.

Fit elderly score higher on tests of fluid intelligence than aged-matched sedentary controls. Elderly patients who have taken part in exercise programs have shown improvement in mental function. We compared the effects of 45 minutes of exercise on memory, mood, and cognitive function in elderly subjects to a control intervention using a randomized control study design.

Performance of patients with a "frozen pelvis" in an in vitro fertilization program.

It is now possible to identify and study the performance of different subgroups of patients in in vitro fertilization (IVF) programs. Patients with severe pelvic adhesions due to pelvic inflammatory disease (PID) or endometriosis were classed as having a frozen pelvis if less than or equal to 20% of total ovarian surface was visible and if the rest of the ovary was bound down with significant adhesions. IVF offers the only hope of pregnancy for these patients.

A laparoscopic approach to a program of gamete intrafallopian transfer.

Gamete intrafallopian transfer (GIFT) provides an effective method of achieving pregnancy in infertile women with normal fallopian tubes. Laparoscopic approach to ovum pickup and tubal catheterization provides a simple and rapid means of performing the operation. Equipment used to facilitate this process is described, and techniques of tubal catheterization are discussed.

Cross-over trial of superovulation protocols from two major in vitro fertilization centers.

A study was undertaken as a controlled comparison of two different superovulation induction protocols currently in use in major Australian in vitro fertilization (IVF) clinics. Thirty patients each from the Monash University and the Royal Women's Hospital (RWH) IVF programs were stimulated for ovulation induction by the other program. Once timing for oocyte retrieval was scheduled, all care reverted to the program from which the patient first came.

Hemodynamic management in clinical acute hypoxemic respiratory failure. Dopamine vs dobutamine.

We investigated short-term hemodynamic effects of dopamine and dobutamine in eight patients with acute hypoxemic respiratory failure. We tested the hypothesis that for a similar increase in cardiac output, left ventricular filling pressure (pulmonary capillary wedge pressure [PCWP]) would increase with dopamine and decrease with dobutamine. Dopamine increased cardiac output (p less than 0.

Effects of noradrenaline and isoproterenol on cardiopulmonary function in a canine model of acute pulmonary hypertension.

The authors investigated acute cardiopulmonary effects of noradrenaline and isoproterenol infusion in a canine model of increased pulmonary vascular resistance (PVR) and decreased cardiac output (CO). In six anesthetized, ventilated dogs, autologous blood clots were injected over approximately two hours to increase right ventricular (RV) afterload and decrease CO. After CO had decreased 40 percent dogs were treated with noradrenaline or isoproterenol in alternate sequence.

Use of sodium bicarbonate to treat tricyclic antidepressant-induced arrhythmias in a patient with alkalosis.

Sodium bicarbonate has been recommended for the treatment of arrhythmias induced by tricyclic antidepressants. It is unclear, however, whether this therapy is effective only in the presence of acidosis. A case is presented in which there was an immediate response to sodium bicarbonate in three episodes of ventricular tachycardia despite the presence of alkalosis on two of the three occasions.

Effects of hydralazine and nitroprusside on cardiopulmonary function when a decrease in cardiac output complicates a short-term increase in pulmonary vascular resistance.

We investigated the short-term cardiopulmonary effects of nitroprusside and hydralazine when cardiac output (CO) was reduced by a short-term increase in pulmonary vascular resistance (PVR). In six anesthetized, ventilated dogs, small autologous blood clots, injected over 1 to 2 hr, increased right ventricular afterload. When CO had fallen approximately 40%, dogs were treated with nitroprusside and subsequently with hydralazine.

A prospective study of beta HCG radioimmunoassay in the diagnosis of ectopic and other complicated early pregnancies.

The beta-subunit of chorionic gonadotrophin (beta HCG) was measured by radioimmunoassay in the serum of 190 consecutive patients admitted to hospital with the suspicion of ectopic pregnancy. The detection limit was set at 1 ng/ml. A urine sample was also taken for pregnancy testing on admission.