EDTA reduces liver cholesterol content in cholesterol-fed rabbits.

A study conducted in 1953 by one of the authors (H.S.M. Uhl) reported that orally administered ethylenediamine tetraacetic acid (EDTA) both prevented the accumulation of cholesterol in the liver of cholesterol-fed rabbits and caused the removal of accumulated cholesterol from the liver. These observations were made in rabbits fed high concentrations of cholesterol and have never been confirmed in the literature. The purpose of the present study was to determine if this original observation could be confirmed using lower amounts of dietary cholesterol and more modern and comprehensive methods for analysis of tissue lipids and plasma lipoproteins. New Zealand White rabbits were fed diets containing 0.1% cholesterol with or without EDTA (3 g/day). After 16 weeks, significantly lower concentrations of hepatic cholesterol were found in rabbits fed EDTA (6.95 mg/g wet weight) compared with controls fed the same cholesterol-containing diet without EDTA (16.6 mg/g wet weight). Plasma cholesterol levels in both groups of animals were not significantly different from one another; therefore, the effect of EDTA in reducing liver cholesterol accumulation was independent of changes in plasma cholesterol concentrations. Although the mechanism of this EDTA effect is unknown, it may provide a tool to gain further insight into mechanisms of regulation of hepatic lipoprotein and cholesterol metabolism.

Longitudinal neuropsychological changes in a "normal" elderly group.

The need for age-related normative data on neuropsychological measures is clearly important. This longitudinal study examines a "normal" elderly group's performance on the Luria-Nebraska Neuropsychological Battery (LNNB) across four years. This report is based on the 59 "normal" elderly volunteers seen in an earlier cross-sectional aging study (MacInnes et al., 1983). The LNNB Clinical Scales exhibited few significant changes across the four year time period. The test-retest correlations of the LNNB Clinical Scales ranged from.32 to.81. Few differences between males and females were seen. Similarly, being in an older subgroup did not affect the rate of change on the LNNB scores. Although, health status changed very little over the four years, health status at Time 2 did significantly predict 16 of the 17 LNNB Clinical Scales at Time 2. In summary, we found the LNNB accurately identified the "normal" elderly as normal. Similarly, their performance on the LNNB exhibited little meaningful change across four years.

Aging, regional cerebral blood flow, and neuropsychological functioning.

Previous studies found changes in regional cerebral blood flow (rCBF) patterns related to both age and various cognitive tasks. However, no study has yet demonstrated a relationship between rCBF and performance on the Luria-Nebraska Neuropsychological Battery (LNNB) in an elderly group. Seventy-nine elderly volunteers (56-88 years old), both healthy and demented, underwent the 133xenon inhalation rCBF procedure and were given the LNNB. The decrements in the gray-matter blood flow paralleled decrements in performance on the LNNB. Using partial correlations, a significant proportion of shared variance was observed between gray-matter blood flow and the LNNB scales. However, there was much less of a relationship between white-matter blood flow and performance on the LNNB. This study suggests that even within a restricted age sample rCBF is related in a global way to neuropsychological functioning.

Aging and performance on the Luria-Nebraska neuropsychological battery.

The Luria-Nebraska Battery has been shown to be a valid measure of neuropsychological functioning in younger adults; however, little validity research with the elderly has been reported. Seventy-eight healthy elderly adults (mean age = 72.2 years) were tested with the Luria-Nebraska Battery and 92% of the profiles were found to be within normal limits. Significant age-related effects were also found on the Luria-Nebraska Battery. Similarly, the healthy elderly were divided into two age groups, young-old (60-74) and old-old (75+). Only the expressive speech and writing scales showed significant differences, and these were in the opposite direction one might expect, in that the old-old group performed significantly better. Additionally, the performance of 100 elderly brain damaged patients (mean age = 68 years) was examined and 86% of the profiles indicated the presence of brain damage. Overall, this study suggests that the Luria-Nebraska Battery may be a useful measure of neuropsychological functioning in elderly groups.

Evaluation of a limited drug formulary in an adult internal medicine clinic.

The utility of a 30-drug, limited formulary in an adult internal medicine, ambulatory-care clinic was investigated. The formulary was developed using a mail survey of a random sample of members of the ASHP Ambulatory Care Pharmacy Practice Special Interest Group. The consensus formulary comprised the 30 most frequently recommended drugs; the utility of the formulary was then tested by chart review in a primary-care internal medicine clinic. Over a two-month period, the charts of alternating patients were reviewed daily; patient data collected included demographic information and prescribed drug therapy. A panel of two physicians and one pharmacist reviewed each patient's data and determined the appropriateness of drug treatment. If an agent was prescribed that was not on the consensus formulary, the panel determined whether an appropriate formulary agent could have been prescribed. Of the prescribed drug orders, 57.8% were for agents in the consensus formulary; by including patients who could have received formulary drugs appropriately, 73.7% of all prescription orders were or could have been for formulary drugs. Age, race, and sex of patients had no significant effect on utility of formulary agents. Had the 30 drugs most commonly prescribed in this clinic been in the formulary, 82.6% of all prescription orders would have been covered. This approach to establishing a new formulary and selecting drugs for inclusion is potentially useful.