(99m)Tc-MIBI Uptake in a Thyroid Adenoma with Diffuse Adipose Metaplasia

A 71-year-old female underwent a (99m)Tc-MIBI scan to characterize a cold nodule (30 mm) of the left thyroid lobe. The nodule showed diffuse uptake and retention of the radiotracer. After resection, histological examination demonstrated a microfollicular adenoma with diffuse white adipose metaplasia. Although mitochondria in brown adipose tissue have been widely studied, we have only a limited understanding of the relevance of mitochondria in white adipose tissue. Active mitochondria are present in white adipocytes, and this may account for the MIBI uptake, mimicking a hyperproliferation pattern, in our patient^.     

Cardiovascular disease and hypertension in sub-Saharan Africa: burden,risk and interventions

Cardiovascular disease, including stroke, heart failure and kidney disease, has been common in sub-Saharan Africa for many years, and rapid urbanization is causing an upsurge of ischaemic heart disease and metabolic disorders. At least two-thirds of cardiovascular deaths now occur in low- and middle-income countries, bringing a double burden of disease to poor and developing world economies. High blood pressure (or hypertension) is by far the commonest underlying risk factor for cardiovascular disease. Its prevention, detection, treatment and control in sub-Saharan Africa are haphazard and suboptimal. This is due to a combination of lack of resources and health-care systems, non-existent effective preventive strategies at a population level, lack of sustainable drug therapy, and barriers to complete compliance with prescribed medications. The economic impact for loss of productive years of life and the need to divert scarce resources to tertiary care are substantial.     

Software Architecture for Smart Emotion Recognition and Regulation of the Ageing Adult

This paper introduces the architecture of an emotion-aware ambient intelligent and gerontechnological project named “Improvement of the Elderly Quality of Life and Care through Smart Emotion Regulation”. The objective of the proposal is to find solutions for improving the quality of life and care of the elderly who can or want to continue living at home by using emotion regulation techniques. A series of sensors is used for monitoring the elderlies’ facial and gestural expression, activity and behaviour, as well as relevant physiological data. This way the older people’s emotions are inferred and recognized. Music, colour and light are the stimulating means to regulate their emotions towards a positive and pleasant mood. Then, the paper proposes a gerontechnological software architecture that enables real-time, continuous monitoring of the elderly and provides the best-tailored reactions of the ambience in order to regulate the older person’s emotions towards a positive mood. After describing the benefits of the approach for emotion recognition and regulation in the elderly, the eight levels that compose the architecture are described.     

Recent Advances in Leukoaraiosis: White Matter Structural Integrity and Functional Outcomes after Acute Ischemic Stroke

Leukoaraiosis, a radiographic marker of cerebral small vessel disease detected on T2-weighted brain magnetic resonance imaging (MRI) as white matter hyperintensity (WMH), is a key contributor to the risk and severity of acute cerebral ischemia. Prior investigations have emphasized the pathophysiology of WMH development and progression; however, more recently, an association between WMH burden and functional outcomes after stroke has emerged. There is growing evidence that WMH represents macroscopic injury to the white matter and that the extent of WMH burden on MRI influences functional recovery in multiple domains following acute ischemic stroke (AIS). In this review, we discuss the current understanding of WMH pathogenesis and its impact on AIS and functional recovery.     

Central Nervous System Device Infections

Nosocomial meningitis can occur in association with central nervous system (CNS) devices such as cerebrospinal shunts or drains, intrathecal pumps, and deep brain stimulators and carry substantial morbidity and mortality. Diagnosing and treating these infections may be challenging to physicians as cerebrospinal fluid cultures may be negative due to previous antibiotic therapy and cerebrospinal abnormalities may be secondary to the primary neurosurgical issue that prompted the placement of the CNS device (e.g., “chemical meningitis” due to intracranial hemorrhage). Besides antibiotic therapy given intravenously and sometimes intrathecally, removal of the device with repeat cultures prior to re-implantation is key in achieving successful outcomes.     

Usefulness of the Polypill for the Prevention of Cardiovascular Disease and Hypertension

Cardiovascular disease (CVD) remains the leading cause of death in the developed countries and is estimated to be the leading cause of death in the developing countries by the year 2030. The cause for this rise in CVD is the increase in the major CVD risk factors (CVRFs) like hypertension, obesity, diabetes, and hyperlipidemia, which account for 80 % of all CVD deaths worldwide. In order to prevent the increase in CVD, it has been proposed to develop a low-cost polypill containing four to five generic drugs with known effectiveness in the reduction of the CVRFs. This polypill has now been tested in several recent studies for the primary and secondary prevention of CVD and stroke with fairly good results. A Medline search of the English language literature between 2011 and 2015 resulted in the identification of 15 studies with pertinent findings. These findings together with collateral literature will be discussed in this review.