Individual analysis of EEG frequency and band power in mild Alzheimer's disease.

OBJECTIVE: This EEG study investigates the role of the cholinergic system, cortico-cortical connections, and sub-cortical white matter on the relationship between individual EEG frequencies and their relative power bands. METHODS: EEGs were recorded at rest in 30 normal elderly subjects (Nold), 60 mild Alzheimer disease (AD) and 20 vascular dementia (VaD) patients, comparable for Mini Mental State Evaluation scores (MMSE 17-24). Individual EEG frequencies were indexed by the theta/alpha transition frequency (TF) and by the individual alpha frequency (IAF) with power peak in the extended alpha range (5-14 Hz). Relative power was separately computed for delta, theta, alpha1, alpha2, and alpha3 bands, on the basis of the TF and IAF. RESULTS: Using normal subjects as a reference, VaD patients showed 'slowing' of alpha frequency (TF-IAF) and lower alpha2 power; Mild AD patients showed lower alpha2 and alpha3 power; delta power was higher in both AD and VaD patients; Theta power was higher only in VaD patients. CONCLUSIONS: Individual analysis of the alpha frequency and power can discriminate mild AD from VaD and normal elderly subjects. SIGNIFICANCE: This analysis may probe pathophysiological mechanisms causing AD and VaD.     

Massive intracranial bleeding due to the rupture of a rare spontaneous pseudoaneurysm of the middle cerebral artery in a pediatric patient: case report with clinical,radiological, and pathologic findings

Forensic Science, Medicine and Pathology - Intracranial pseudoaneurysm (IPA) is a rare but likely underdiagnosed cause of intracranial hemorrhage, which accounts for just 1–6% of all...     

Variations of ornithine decarboxylase activity and S-adenosyl-L-methionine and 5'-methylthioadenosine contents during the development of diethylnitrosamine-induced liver hyperplastic nodules and hepatocellular carcinoma

Liver ornithine decarboxylase (ODC) activity and content ofS-adenosyl-L-methionine (SAM) and its catabolite 5'-methyl-thioadenosine(5'-MTA) were determined in the late stages of hepatocarcinogenesis.Wistar rats received one diethyl-nitrosamine dose, followedby a partial hepatectomy at the midpoint of a 15-day treatmentwith 2-acetylaminofluorene (2-AAF), and then by an 18-week phenobarbital(PB) treatment. Thirty-eight per cent of liver was -glutamyltranspeptidase(GGT)-positive and no visible nodules and hepatocellular carcinomasdeveloped 16 weeks after starting 2-AAF feeding. Hyperplasticnodules and hepatocellular carcinomas were found on weeks 24and 56 respectively. On weeks 24 and 56 only 10% of liver wasoccupied by GGT-positive foci. At all times studied the fociexhibited a low labeling index (LI), and liver ODC activitywas near control values. By contrast, a high ODC activity andLI and a low SAM and 5'-MTA levels were found in hyperplasticnodules and neoplasia. These tissues exhibited a high 5'-MTAphosphorylase activity. SAM administration during PB treatment,caused a 25–36% fall of GGT-positive liver and preventedthe development of hyperplastic nodules and hepatocellular carcinomas.This was coupled to a sharp increase of SAM and 5'-MTA livercontents. SAM and 5'-MTA inhibited hepatocyte DNA synthesisin vitro. The addition of 5'-MTA to the reaction mixture forthe ODC assay strongly inhibited ODC activity. However, thepreincubation of SAM with liver homogenates or hepatocytes,used to prepare crude ODC, was necessary to inhibit ODC activityby SAM. Adenine, an inhibitor of 5'-MTA-phosphorylase, enhancedinhibition of DNA synthesis and ODC activity by SAM and 5'-MTA.Thus, during a prolonged promoting treatment a selected populationof GGT-positive foci appears to acquire a stable phenotype characterizedby a high DNA and polyamine synthesis. The development of nodulesand carcinomas is associated with low SAM and 5'-MTA contentsand high ODC activity and LI. 5'-MTA accumulation, during SAMadministration, is probably responsible for the inhibition ofpromotion by SAM.     

Environmental impacts of household appliances in Europe and scenarios for their impact reduction

Assessing the environmental impact due to consumption of goods and services is a pivotal step towards achieving the sustainable development goal related to responsible production and consumption (i.e. SDG 12). Household appliances plays a crucial role and should be assessed in a systemic manner, namely considering all life cycle stages, technological efficiency, and affluence aspects. The present study assess the impact of such household appliances used in Europe, and tests scenarios of potential impact reduction at various scales. Life cycle assessment is applied to 14 different household appliances (ranging from dishwashers to television devices) selected to build a set of representative products, based on their economic value and diffusion in households in Europe. Related impacts are calculated with the Environmental Footprint method for calculating a Consumer Footprint “appliances” for the baseline year 2010. A number of scenarios encompassing eco-solutions on a technical level, changes in consumption pattern, behavioral changes, as well as the combination of all these aspects are run to estimate the Consumer Footprint related to household appliances for the year 2030, compared against this baseline scenario. The baseline Consumer Footprint is confirming the importance of the use phase in leading the impacts in almost all impact categories. Testing different scenarios concludes that there is a reduction of the impact for most of the categories (with up to 67% for the ozone depletion potential, and still around 35% for the global warming potential), while two of the here examined impact categories (i.e. land-use and mineral resource depletion) show an overall potential that is even negative – i.e. the results of all scenarios are higher than the ones of the 2010 baseline scenario. The increase in purchase and use of such appliances may offset energy efficiency benefits in some of the examined categories. Hence, the assessment of sustainability of appliances consumption should always include several scales, from the efficiency of the products (micro scale), to the improvement of the energy mix (meso scale), up to accounting for socio-economic drivers and patterns of consumption affecting the overall appliances stock (macro scale).     

A 4-year survey on palivizumab respiratory syncytial virus (RSV)-prophylaxis: how can compliance be improved?

OBJECTIVE: To identify compliance-influencing factors and to suggest strategies for overcoming barriers in a preventive medicine program. METHODS: A survey was conducted to evaluate compliance in children receiving palivizumab prophylaxis for respiratory syncytial virus (RSV) infections. Demographics, neonatal variables, and parental attitudes capable of influencing the outcome of prophylaxis were studied in 216 children over a four-year period. RESULTS: The overall compliance rate with all recommended doses of palivizumab was 87%. Among the neonatal characteristics, low birth weight and a younger age at the beginning of the program were significantly associated with good compliance (p < 0.05). The strongest factor influencing poor compliance was being foreign-born or a non-native speaker (p < 0.01). CONCLUSIONS: Compliance to RSV infection prophylaxis is reduced in infants born to foreign-born or non-native speakers. In order to enhance compliance, parents should be provided with adequate information in their own language explaining the advantages of the palivizumab prophylaxis program for RSV infections.     

Norovirus in captive lion cub (Panthera leo)

African lions (Panthera leo) are susceptible to viral diseases of domestic carnivores, including feline calici-virus infection. We report the identification of a novel enteric calicivirus, genetically related to human noroviruses of genogroup IV, in a lion cub that died of severe hemorrhagic enteritis.     

Regulation of treatment of infants at the edge of viability in Italy: the role of the medical profession?

In the last few years there has been intense debate in Italy on administration of life-prolonging treatment to premature babies at the edge of viability. In 2006, a group of experts based in Florence drafted recommendations known as Carta di Firenze (CdF) for responsible use of intensive care for premature infants between 22 and 25 weeks of gestational age (GA). The CdF was later endorsed by several medicoprofessional associations, but was followed by recommendations by the Ministry of Health mandating resuscitation for all premature babies regardless of GA and parental consent. Recent statements from medicoprofessional bodies seem to show that the 'always resuscitate rule' is not supported by many Italian doctors. We argue that ethically sensitive issues in medicine should be regulated with, and not against, the medical profession and its representative bodies.     

Role of psoriasis as independent predictor of cardiovascular disease: A meta-regression analysis

Background

Despite the proved association between psoriasis and cardiovascular risk exposure, there are no data about the role of psoriasis as an independent predictor of such risk. The aim of this study was to investigate whether any association between psoriasis and excess cardiovascular risk exposure is independent from confounding factors.

Methods

Meta-analysis and meta-regression analysis were performed using data extracted from observational studies (identified by MEDLINE, EMBASE and CINAHL) investigating the relationship between psoriasis and cardiovascular disease with at least 6 points on the New Castle-Ottawa quality scale. Two reviewers with methodological expertise conducted data extraction independently.

Results

Thirteen studies including patients with psoriasis showed an increased risk of cardiovascular disease (RR = 1.24 [1.18–1.31]; P = 0.0001). These patients still presented a significantly larger cardiovascular risk in the presence of smoking (RR = 1.14 [CI = 1.13–1.15] P < 0.0001), obesity (RR = 1.11 [CI = 1.07–1.14] P = 0.0003) and hyperlipidemia (RR = 1.05 [CI = 1.03–1.07] P = 0.0006), but not in the presence of hypertension (RR = 1.03 [CI = 0.98–1.09] P = 0.4647) and diabetes (RR = 0.95 [CI = 0.90–1.01] P = 0.6502).

Conclusions

Patients with psoriasis carry an about 25% increased relative risk of cardiovascular disease. This risk appears to be independent of smoking, obesity and hyperlipidemia.     

Long-term outcome in patients with non-valvular atrial fibrillation on dabigatran: a prospective cohort study

ABSTRACT

Introduction: Most studies on thromboembolic and bleeding risk in patients with non-valvular atrial fibrillation (NVAF) exposed to non-vitamin K oral anticoagulants stem from interrogation of insurance databases.

Areas covered: We studied 742 consecutive patients with NVAF who started treatment with dabigatran in three hospitals in Italy. Average follow-up was 1.80 years.

Mean age was 76.2 years. CHA₂DS₂VASc score was 0–1 in 37 (5%), 2 in 97 (13%) and ≥ 3 in 604 (82%) patients. NVAF was permanent in 349 (48%). Overall, 76% of patients remained on treatment over the entire follow-up period. Among 180 patients who discontinued permanently, the most frequent reasons were dyspepsia (33.9%), bleeding (17.8%), and renal worsening (12.1%). About 48% and 74% of permanent discontinuations occurred during the first 6 and 12 months of treatment, respectively. Rates of major events (per 100 patient-years) were 0.75 for stroke, 0.31 for myocardial infarction, 1.50 for all-cause death, and 1.80 for major bleedings. The rate of intracranial bleedings was 0.45 and that of major gastrointestinal bleedings was 0.75.

Expert opinion: This prospective cohort study confirms the low incidence of stroke, major bleeding and intracranial bleeding, and a 76% persistence with treatment, in patients with NVAF treated with dabigatran over about 2 years.