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Demencia prevenció: A korai diagnózistól a személyre szabott intervencióig

Dementia Prevention: From Early Diagnosis to Personalised Intervention

Scientia et Securitas
Authors: Annamária Manga, Menta Havadi-Nagy, Orsolya Székely, and Zoltán Vidnyánszky

Összefoglaló. Az elmúlt évtizedekben a várható élettartam emelkedésével drámai mértékben nőtt a demencia előfordulásának gyakorisága, melynek hátterében leggyakrabban az Alzheimer-kór áll. A rendkívül ígéretes, biomarkereken, agyi képalkotáson és mesterséges intelligencián alapuló megközelítéseknek köszönhetően egyre szélesebb körű információink vannak a betegség kialakulásáról és lefolyásáról, új kapukat nyitva ezzel a demencia korai diagnózisa és a személyre szabott terápia felé. Míg az új kutatási irányzatok előnye vitathatatlan, a nagy mennyiségű kutatási adat kezelése, illetve a betegség korai szakaszban történő azonosítása több biztonsági kérdést felvet. A korai diagnózis mellett egyre nagyobb hangsúly helyeződik az intervencióra, a demenciára hajlamosító tényezőkbe történő beavatkozás által.

Summary. As a consequence of increasing life expectancy, the number of those living with dementia is rising. While Alzheimer’s disease (AD) constitutes the most common cause of dementia, the origin of AD is unknown. Furthermore, in the absence of effective treatment, therapy focuses on the cognitive and behavioural symptoms of the disease, and the wellbeing of the patient. AD is characterised by a pronounced impairment experienced in one or more cognitive domains, and the criterion of the diagnosis is the presence of aggregated proteins in the brain leading to neuron death, and eventually to the loss of cognitive abilities.

As a result of the latest technological advances, several biological markers (biomarkers) of AD pathology were identified. The biomarkers can be obtained using positron emission tomography or measured from cerebrospinal fluid, and lately from blood serum and plasma as well. Magnetic resonance imaging provides an important measure of brain atrophy, a biomarker of neurodegeneration and neuronal injury. The structure of the brain shows significant alterations as a function of neuronal loss, with cortical thinning and tissue density changes, mainly starting from the medial temporal lobes (also including the hippocampus playing a prominent role in memory functions), and extending to the temporoparietal regions, with observed changes in the activity of the different functional brain networks as well.

A major challenge in defeating AD is that in most cases, the disease is recognised subsequent to the appearance of the decline in cognitive abilities, hampering everyday life. Previous studies identified a preclinical stage of AD, where the biomarkers indicative of the disease are present in the absence of detectable cognitive symptoms. This early, preclinical stage – with the use of artificial intelligence-based techniques – has been suggested to be a promising window for the early detection of the disease, and also for the prediction of individual disease trajectories, allowing for the thorough planning of patient management. While the benefit of the early diagnosis is unequivocal, it raises a number of important ethical and safety issues.

Besides the tremendous effort of developing effective medical treatments, the importance of intervention stands in the centre of scientific interest. The proposed prevention and intervention methods target the potentially modifiable risk factors of dementia, encouraging engagement in stimulating everyday activities and healthy lifestyle, to preserve longevity.

Open access
Acta Alimentaria
Authors: J. Juskiewicz, M. Wróblewska, K. Zhaki, Z. Zdunczyk, and L. Hussein

The objective of the experiment was to determine whether small amounts of proanthocyanidins (0.1 and 0.3%) may increase the antioxidative properties of the rat diet without exerting an antinutritional effect. Proanthocyanidins of faba bean seed coats were extracted with a mixture of acetone and water (70:30) and lyophilized. The amount of proanthocyanidins was two- or fourfold higher in the experimental diets as compared to the control diet. The addition of proanthocyanidin extract had no significant effect on the coefficients of digestibility of crude protein, daily nitrogen retention and the coefficient of biological value of diet protein. In the blood serum of rats fed diets supplemented with proanthocyanidin extract, there was a slightly higher content of vitamin E and alanine aminotransferase activity, while the content of vitamin A and aspartate aminotransferase activity were similar to those of the control group. In the contents of the rat gut (caecum), a lower activity of â -glucuronidase was found as compared to the control group, whereas â -galactosidase was unaffected. The addition of proanthocyanidin extract to diet caused a decrease in the malondialdehyde content in the heart, kidneys, erythrocytes and blood plasma of rats. The results obtained indicate that the amount of proanthocyanidins used did not exert any antinutritional effects, but extended the pool of diet antioxidants and beneficially affected the activity of the large bowel microflora.

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Acta Alimentaria
Authors: T. Kośla, M. Skibniewski, E. Skibniewska, and G. Urbańska-Słomka

. Diss. Dr.habil., Fac. Med. Vet., Univ. Leipzig. Koşala, T. (1992): The contens of macro- and microelements in the fodder, blood serum and hair of European bison. Part II. Iron, copper and zinc. Ann. Warsaw

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determination of acetone and β-ketobutyric acid in blood serum by means of head space gas sampling. Clin. chim. Acta , 28 , 233-237. A simple gas chromatographic determination of acetone and β-ketobutyric acid in blood serum by means

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