Cerebral glucose metabolism in Parkinson's disease with and without dementia.

Although cognitive impairment is commonly associated with Parkinson's disease, the relative importance of cortical and subcortical pathologic changes to the development of dementia is controversial. Characteristic abnormalities in cortical glucose metabolism have been reported previously in Alzheimer's disease, a disease in which cortical changes predominate. We measured cerebral glucose metabolism with positron emission tomography in 20 control subjects and in 14 patients with PD with mental status ranging from normal to severely demented to determine whether changes in cortical glucose metabolism occur in early PD and whether the degree and pattern of metabolic change relate to the severity of dementia. The patients were divided into demented and nondemented groups according to the results of neuropsychological assessment. Age-adjusted covariance analyses were performed, since the age distribution varied between groups. The nondemented patients with PD showed widespread cortical glucose hypometabolism without any selective temporoparietal defects. The pattern of glucose hypometabolism seen in the demented patients with PD resembled that described in patients with Alzheimer's disease; ie, there was a global decrease in glucose metabolism, with more severe abnormalities observed in the temporoparietal regions.     

Effects of captopril chronic intake on the aerobic performance and muscle strength of normotensive trained subjects.

Fifteen normotensive athletes specializing in dynamic sports took part in a randomized double-blind and cross-over study: captopril (50 mg/24 h) vs placebo. Each treatment lasted one month. Maximal exercise tests on cycle ergometer were performed at the end of each period. No significant differences were observed in the maximal values of oxygen uptake, power, heart rate or blood lactate value. The anaerobic threshold, defined as the exercise intensity which corresponded to a 4 mmol.l-1 blood lactate level was unchanged. With captopril, the end-of-exercise systolic and diastolic BP were slightly altered (NS). Lower limb muscle strength, as explored with a Cybex isokinetic system, was not modified by captopril intake. The results indicate that maximal aerobic performance and isokinetic strength of the lower limbs are not altered by captopril chronic administration (50 mg/day) in normotensive trained subjects.     

Triamterene nephrolithiasis: renewed attention is warranted

Although triamterene has been known to contribute to urinary calculus formation, it has been presumed to be a rare phenomenon. Our review of stone analyses performed during the last decade by a single laboratory reveals an increasing incidence of triamterene stones. Awareness of the calculogenic potential of triamterene-containing medications should be re-emphasized.     

Disseminated intravascular coagulation: pathogenesis, diagnosis, and therapy

Disseminated intravascular coagulation (DIC), resulting in an acute bleeding diathesis, is always a secondary complication of an underlying disease. Coagulation triggered by the primary process causes consumption of clotting factors and platelets, and ischemic damage secondary to fibrin deposition. Concurrent activation of the fibrinolytic system results in additional clotting factor consumption and the production of fibrin-degradation products (FDP). The combination of decreased clotting factors, FDP, and thrombocytopenia may ultimately culminate in a bleeding diathesis. The balance between the thrombotic and hemorrhagic processes results in a constellation of signs and symptoms. Diagnosis depends on an awareness of predisposing pathologic states and the application of appropriate laboratory tests. Therapy consists of treating the underlying disease and temporizing with an appropriate replacement therapy. Heparin infusion may be of benefit under certain circumstances. The pathogenesis, diagnosis, and treatment of DIC, including new laboratory tests and experimental therapy, are reviewed.     

What's in a burger?

In an attempt to confirm the presence or absence of central nervous tissue in commercially prepared beefburgers, four burgers were processed and stained using routine histological laboratory techniques. Constituent parts of the burgers could be identified readily. In this small sample no central nervous tissue was found. There is currently considerable general interest in the contents of foodstuffs, particularly now that certain specified bovine offals as well as central nervous tissue have been banned from human consumption. Conventional histological techniques may be of value in analysing the ingredients of beef products.     

An Atypical Recurrence of Endometrial Carcinoma Following Estrogen Replacement Therapy

Following an abdominal hysterectomy and bilateral salpingoophorectomy wherein a superficial (1.6 mm) well-differentiated endometrial cancer and bilateral ovarian serous cystadenomas were discovered, estrogen replacement was given. One year later the patient presented with a 9 × 7-cm left groin recurrence. Patients with endometrial carcinoma may request estrogen replacement. The benefits of such replacement are well recognized; however, these patients also need to be counselled that hormonal replacement may be complicated by recurrence. Physicians need to be cognizant of symptoms or signs which would suggest disease recurrence at unusual sites in these patients who are perceived as being at low risk for recurrent disease.