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3861. Normal ageing, impaired cognitive function, and senile dementia of the Alzheimer's type: a continuum?
There is little evidence to support the view that senile dementia of the Alzheimer's type (SDAT) is distinct from the normal ageing process. The changes in brain function found in normal ageing, benign senescent forgetfulness, and SDAT can be seen as a continuum, which may reflect a single underlying process. The failure to account for this possibility in research design may explain why few risk factors for SDAT have been identified.
3870. HLA haplotype A1 B8 DR3 as a risk factor for HIV-related disease.
作者: C M Steel.;C A Ludlam.;D Beatson.;J F Peutherer.;R J Cuthbert.;P Simmonds.;H Morrison.;M Jones.
来源: Lancet. 1988年1卷8596期1185-8页
Of 32 patients exposed to a single batch of factor VIII contaminated with human immunodeficiency virus (HIV), 18 became antibody positive. Serial T cell subset analyses over the succeeding four years have shown a progressive decline in circulating T4 cells in those 18 but no change in the 14 who remain seronegative. 2 of the seroconverters have died and a further 7 have symptoms attributable to HIV infection. In the group as a whole, the HLA haplotype A1 B8 DR3 was weakly associated with an increased risk of seroconversion on exposure to the virus while, in those who seroconverted, it was strongly associated with a rapid decline in T4 cells and development of HIV-related symptoms within four years of infection.
3872. Effect of intravenous nitrates on mortality in acute myocardial infarction: an overview of the randomised trials.
About 2000 patients have been randomised in ten trials of intravenous nitroglycerin or nitroprusside in acute myocardial infarction. Taken separately, the individual trials have all been too small to provide a reliable estimate of the effects of treatment on mortality, but collectively they provide strong evidence of benefit. In total there have been 136 nitrate and 193 control deaths, and an appropriate overview of the separate trial results indicated a "typical" reduction of 35% (SD 10) in the odds of death (2p less than 0.001, with 95% confidence limits of about one-sixth to one-half). Both nitroglycerin and nitroprusside reduced mortality, the reduction being non-significantly greater with nitroglycerin than with nitroprusside. The greatest reduction in mortality occurred during the first week or so of follow-up, with a non-significant further reduction after this early period. This suggests that the early benefit is not rapidly lost.
3880. The role of bone-marrow transplants after nuclear accidents.
The probability that bone-marrow transplantation will be beneficial after nuclear accidents depends on several factors, including circumstances of the accident, degree of damage in other body systems, and radiation dose. Transplant-related variables, such as donor-recipient histocompatibility and post-transplant immune suppression, are also important. The benefits of transplantation may result from transient or permanent haemopoietic reconstitution. The balance of potential benefits versus risks should be individually calculated for each accident and each patient; generalisations are likely to result in untenable conclusions.
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