ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

BACKGROUND– Alzheimer's disease (AD) is a progressive dementia associated with distinct neuropathologic changes and characterized by memory loss and impairment in at least one other area of cognition. The underlying neuropathologic substrate for cognitive and noncognitive behavioral disturbances in AD is uncertain, but likely includes deficiencies of cholinergic and other transmitters in addition to plaques and tangles.REVIEW– Therapies based on cholinergic hypotheses have lead to two approved drugs, tacrine and donepezil; other cholinergic drugs, including cholinesterase inhibitors, muscarinic agonists, and nicotinic agonists, are under development. Other therapies have been devised based on presumed risk and protective factors, such as aging, APO E genotype, head trauma, menopause/estrogen deficiency, the effect of education on the brain, anti-inflammatory drugs, and anti-oxidants. Recently, numerous basic studies have demonstrated the significance of amyloid protein, τ protein, and apolipoprotein E in the pathogenesis of plaques and tangles.SUMMARY– Treatment of the cognitive disturbances in AD will likely use multiple approaches to improve symptoms and to slow progression. Therapy for the noncognitive disturbances involves communication between the clinician and the caregiver, as well as pharmacologic and nonpharmacologic treatments.CONCLUSIONS– AD is a heterogeneous disorder. Treatment must be individualized and must address both cognitive and noncognitive disturbances. Future therapies may also take various genetic risk factors and gender into account.

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Residency education in neurology is at the crossroads. Change is imminent. Health care reform, economics, managed care, expanding knowledge base in neurology, shrinking applicant pools, and ill-defined borders between the specialties combine to require neurology to define itself more clearly and to develop the model neurologist for the future. Explicit competencies for neurologists must be established. Training programs must be redesigned to ensure that those specific competencies are taught and mastered before the completion of the residency. Eleven points are offered as a framework for training neurologists for the 21st century.

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID