Daily Archives: March 3, 2017

The Brain Hypometabolism Hypothesis: Part 4 – The Rotterdam Study

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In their paper, Cunnane and colleagues look at the evidence for a role of altered brain metabolism in the development of Alzheimer’s Disease.

One of the lines of evidence is that glucose resistance is associated with an increased risk of Alzheimer’s Disease and one study which supports this is the Rotterdam study.

In the Rotterdam study, the cohort was assessed at baseline in 1990. In this paper, the cohort was followed up for an average of 7.2 years. The HOMA (homeostasis model assessment) index was used for the insulin resistance calculation.

The researchers noted that within the first three years of follow-up, doubling the insulin resistance and insulin levels was correlated with a 40% increase in the risk of Alzheimer’s Type Dementia. However this relationship disappeared after 3 years.

There are a few explanations

  1. There is an intermediate period of increased risk as the body adjusts to newly develop insulin resistance
  2. The researchers were looking at Alzheimer’s Type Dementia rather than Alzheimer’s Disease pathology
  3. The findings would benefit from replication. The problem with this is that there were 22, 494 person years of follow-up. On the other hand 211 participants developed Alzheimer’s Type Dementia.

The study found an inverse relationship between higher levels of glucose and risk of Alzheimer’s Type Dementia which is difficult to interpret. Insulin resistance and Diabetes lead to higher levels of glucose. Again this might relate to point 3 above.

So in summary there is some evidence that insulin resistance is linked to a higher risk of Alzheimer’s Type Dementia. On the other hand this relationship disappears after 3 years and there is an inverse relationship identified with glucose levels.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

Staging and Scales in SNOMED CT®

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In this series of posts I am assessing SNOMED CT® using the international browser.

The SNOMED CT® terminology in the staging and scales section describes scales used in clinical practice as well as pathology staging systems. Scales are also described elsewhere in the SNOMED CT® terminology and there may be benefit from search or text analysis algorithms to enable the clinician to quickly locate the relevant terms.

Appendix A – Other Posts in the Series on Health Information Exchanges

A Literature Review of 40 years of SNOMED

Arizona Statewide Health Information Exchange

A History of The Health Information Exchange in Pennsylvania

The Arkansas Health Information Exchange – SHARE

The California Health Information Exchange – Cal Index

Creating a Health Information Exchange in Arizona

Health Information Exchanges

Health Information Exchanges and Chronic Conditions

HIPPA and Health Information Exchanges

ICD-11 and SNOMED CT®

ICD-SNOMED-CT® Harmonisation

Physical Objects in SNOMED CT®

ICD-1 – Well…near enough

ICD-2

ICD-3

ICD-4

ICD-5

ICD-6

ICD-7

ICD-8

ICD-9

ICD-10

ICD-11

Körner Data and SNOMED: A Snapshot from 1988

Mapping ICD 9 (or 10) to SNOMED CT®

Over 1 Million Relationships: SNOMED CT ®

SNOMED CT® International Browser

SNOMED CT® Utilises the Brodmann Area Classification for Brain Regions

The Insular Cortex and SNOMED CT®

Administrative Statuses in SNOMED CT®

Environment Descriptors in SNOMED CT®

Event Descriptors in SNOMED CT®

Generic Specifiers in SNOMED CT®

Physical Forces in SNOMED CT®

The Classification of Life in SNOMED CT®

Procedure Descriptors in SNOMED CT®

Observable Phenomenon in SNOMED CT®

Medication in SNOMED CT®

Specific Situations in SNOMED CT®

Social Concepts in SNOMED CT®

Special Concepts in SNOMED CT®

Specimens in SNOMED CT®

What’s a Kinkajou got to do with 21st Century Medical Terminology?

Standardisation of Health Information Technology in New Zealand

Statisticians were Responsible for the Development of an International Classification of Diseases

Why Do We Need Electronic Record Systems to Talk to Each Other

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.