Progressive supranuclear palsy: Neuropathology of patients with a short disease duration due to unexpected death

2020 ◽  
Author(s):  
Lu Zhang ◽  
Yasuko Toyoshima ◽  
Akari Takeshima ◽  
Hiroshi Shimizu ◽  
Itsuro Tomita ◽  
...  
2014 ◽  
Vol 73 (Suppl 2) ◽  
pp. 611.1-611
Author(s):  
T. Uhlig ◽  
V. Norvang ◽  
E. Lie ◽  
E. Rødevand ◽  
K. Mikkelsen ◽  
...  

2004 ◽  
Vol 3 (2) ◽  
pp. 56-61
Author(s):  
N. N. Zhilkova

The aim of investigation is to study the state of kallikrein-kinin system (KKS) and proteinase inhibitors at patients with asiderotic anemia prior to and after the treatment. 58 patients with asiderotic anemia prior to the treatment and in dynamics after 3 weeks have been examined. KKS state has been estimated by kallikrein, prekallikrein, proteinase α1-inhibitor (Pα1I) and α2-macroglobulin (α2-MG) levels in blood plasma having been investigated by Paskhina’s et al.chromatographic method and by Nartikova’s and Paskhina’s unified enzymatic method.Patients with asiderotic anemia had the rise of KKS activity. Its change differences depending on the disease duration have been revealed. At short disease duration a regulated KKS activation and its stable state have been marked. After the treatment at patients with medium severity degree it happens a normalization of all KKS parameters, at patients with serious anemia the high activity of Pα1I persists. The continuous treatment of anemia has led to the development of pathological type activation that had persisted at patients after the treatment.It has been revealed that the degree of KKS activation intensity and its renewal after the implemented treatment depended on the duration and severity of the disease.


2021 ◽  
Vol 12 ◽  
Author(s):  
Tao Xie ◽  
Carlen A. Yuen ◽  
Wenjun Kang ◽  
Mahesh Padmanaban ◽  
Timothy C. Hain ◽  
...  

It is an unmet need to estimate survival duration for patients with progressive supranuclear palsy (PSP). The objective of this study was to identify factors associated with the survival duration in patients with PSP. We followed up 23 patients with probable PSP-RS (Richardson syndrome) or PSP-P (parkinsonism) in our PSP center until death from 2011 to 2019. We prospectively and quantitatively rated their downgaze palsy whenever first noticed in our clinic. This was utilized along with the disease duration, motor function, medication use for parkinsonism, sex, age at onset of PSP, comorbid pulmonary and cardiovascular diseases, and the total survival duration from the onset of PSP to death for prediction analysis. A well-fitted linear regression model and a multivariant Cox model were applied to identify predicting factors for total survival duration. All patients had the specific hummingbird sign on brain MRI for PSP when downgaze palsy was documented. We found that the severity of downgaze palsy and the disease duration at the assessment were consistently correlated with the total survival duration in both models. The total survival duration could be further estimated by a formed regression equation. We conclude that severity and time to develop downgaze palsy could help to estimate the total survival duration in patients with probable PSP-RS and PSP-P, the major forms of PSP, which has significant clinical applications in clinical counseling and trial enrollment.


2012 ◽  
Vol 52 (3) ◽  
pp. 156-160
Author(s):  
Yasushi Iwasaki ◽  
Keiko Mori ◽  
Masumi Ito ◽  
Maya Mimuro ◽  
Mari Yoshida

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21505-e21505 ◽  
Author(s):  
Francois-Xavier Goudot ◽  
Milena Maglio ◽  
Sandrine Bretonniere

e21505 Background: According to literature and medical experience, the doctor-patient relationship becomes strained when oncologists tell their patients that they have no more curative treatments to offer them. Patients often resist when they are told that it is in their best interest to meet with the palliative teams. Little is known about how to meet patients’ expectations at this advanced stage. Methods: We conducted a multicenter qualitative research in an oncology department, a hospital at home service and in an inpatient hospice care center. We met 47 patients (M = 21, F = 27, mean age = 65 yrs, mean disease duration = 5 yrs) for in-depth face to face interviews performed by a multi-disciplinary ethics team. Interviews were carried out between 1 and 3 months before death. Results: Qualitative analysis revealed 4 main results. 1/ For respondents, palliative care introduction meant impending death. 2/ Palliative care introduction meant loss of hope. Without hope, the cancer trajectory is impossible to sustain, they said. 3/ Hope was intricately interwoven with the request for more chemotherapy, even if doctors had clearly refused to provide it. 4/ The oncologist remained the referent physician, even for patients in hospice care. Patients for which the mean duration between cancer diagnosis and interview was 5 years or more, were more willing to talk about death and better accepted palliative care than patients for which the mean duration of cancer was inferior to 3 yrs. For patients with fast progressing cancer (n = 11), 10 were not willing to talk about death and 7 strongly resisted palliative care introduction. There was no difference between patients according to age, sex, type of cancer or center of inclusion. Conclusions: In the terminal phase of cancer, patients are unwilling to talk about death and are reluctant to meet with palliative care teams. Short disease duration strongly reinforces this attitude. If patients resist discussions about their impending death, should physicians continue to consider it good practice to introduce such discussions? Is it beneficent for patients?


2020 ◽  
Author(s):  
Edoardo Biancalana ◽  
Federico Parolini ◽  
Alessandro Mengozzi ◽  
Anna Solini

Abstract Background Type 2 diabetes (T2D) shows a high mortality rate, dependent on disease duration, comorbidities and glucose control over time. Data on patients with short disease duration are scanty.Methods We prospectively followed a cohort of newly-diagnosed T2D patients referring to a single diabetes centre, treated according to the international guidelines and checked every 6-12 months. All-cause mortality and major cardiovascular (CV) events were registered.Results 289 patients out of 3019 consecutive first attendances matched inclusion criteria and were included in the observation. Mean follow-up was 51.2 months. At 31 December 2018, 253 patients were alive and 36 deceased. At baseline, deceased individuals were older, with lower eGFR and lower uric acid, higher prevalence of atrial fibrillation. During the follow-up, 18 non-fatal CV events were adjudicated; patients with incident CV disease (CVD) differed at baseline for sex, previous history of CVD and retinopathy, higher use of secretagogues and lower use of metformin. At multivariate analysis, age and previous CVD were the only independent determinants of all-cause mortality and incident CVD, respectively. In deceased individuals, eGFR slope was markedly unstable and ΔeGFR at the end of the follow-up was higher (p<0.001), and predicted mortality. Conclusion Newly-diagnosed T2D patients followed according to the best clinical practice show a mortality rate similar to that reported in more complicated patients with longer disease duration; none of the clinical and biochemical variables commonly measured at baseline can predict mortality or incident CVD; early metformin use seems to be associated with no risk of prevalent or incident retinopathy.


2020 ◽  
Author(s):  
Edoardo Biancalana ◽  
Federico Parolini ◽  
Alessandro Mengozzi ◽  
Anna Solini

Abstract Background Type 2 diabetes (T2D) shows a high mortality rate, dependent on disease duration, comorbidities and glucose control over time. Data on patients with short disease duration are scanty. Methods We prospectively followed a cohort of newly-diagnosed T2D patients referring to a single diabetes centre, treated according to the international guidelines and checked every 6-12 months. All-cause mortality and major cardiovascular (CV) events were registered. Results 289 patients out of 3019 consecutive first attendances matched inclusion criteria and were included in the observation. Mean follow-up was 51.2 months. At 31 December 2018, 253 patients were alive and 36 deceased. At baseline, deceased individuals were older, with lower eGFR and lower uric acid, higher prevalence of atrial fibrillation. During the follow-up, 18 non-fatal CV events were adjudicated; patients with incident CV disease (CVD) differed at baseline for sex, previous history of CVD and retinopathy, higher use of secretagogues and lower use of metformin. At multivariate analysis, age and previous CVD were the only independent determinants of all-cause mortality and incident CVD, respectively. In deceased individuals, eGFR slope was markedly unstable and ΔeGFR at the end of the follow-up was higher (p<0.001), and predicted mortality. Conclusion Newly-diagnosed T2D patients followed according to the best clinical practice show a mortality rate similar to that reported in more complicated patients with longer disease duration; none of the clinical and biochemical variables commonly measured at baseline can predict mortality or incident CVD; early metformin use seems to be associated with no risk of prevalent or incident retinopathy.


Sign in / Sign up

Export Citation Format

Share Document