scholarly journals Etiology of Dementia in Thai Patients

2021 ◽  
pp. 64-70
Author(s):  
Pornpatr A. Dharmasaroja ◽  
Jintana Assanasen ◽  
Sunsanee Pongpakdee ◽  
Kankamol Jaisin ◽  
Praween Lolekha ◽  
...  
Keyword(s):  
Molecular Imaging ◽  
Functional Imaging ◽  
Lewy Bodies ◽  
Primary Progressive Aphasia ◽  
Cortical Atrophy ◽  
Common Cause ◽  
Presenting Symptoms ◽  
Dementia Registry ◽  
The Mean ◽  
Baseline Characteristics

<b><i>Introduction:</i></b> Molecular imaging has been developed and validated in Thai patients, comprising a portion of patients in the dementia registry. This should provide a more accurate diagnosis of the etiology of dementia, which was the focus of this study. <b><i>Methods:</i></b> This was a multicenter dementia study. The baseline characteristics, main presenting symptoms, and results of investigations and cognitive tests of the patients were electronically collected in the registry. Functional imaging and/or molecular imaging were performed in patients with an equivocal diagnosis of the causes of dementia, especially in atypical dementia or young onset dementia (YOD). <b><i>Results:</i></b> There were 454 patients in the study. The mean age of the patients was 78 years, with 60% female. Functional imaging and/or molecular imaging were performed in 57 patients (57/454 patients, 13%). The most common cause of dementia was Alzheimer’s disease (AD; 50%), followed by vascular dementia (VAD; 24%), dementia with Lewy bodies (6%), Parkinson’s disease dementia (6%), frontotemporal dementia (FTD; 2.6%), progressive supranuclear palsy (2%), multiple system atrophy (0.8%), and corticobasal syndrome (0.4%). YOD accounted for 17% (77/454 patients), with a mean age of 58 years. The causes of YOD were early onset amnestic AD (44%), VAD (16%), behavioral variant FTD (8%), posterior cortical atrophy (6.5%), and logopenic variant primary progressive aphasia (5.2%). <b><i>Conclusion:</i></b> AD was the most common cause of dementia in Thai patients and the distribution of other types of dementia and main presenting symptoms were similar to previous reports in Western patients; however, the proportion of YOD was higher.

What is dementia?

2021 ◽  
pp. 3-10
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Primary Care ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Primary Progressive Aphasia ◽  
Normal Pressure ◽  
Primary Care Providers ◽  
Care Providers ◽  
Common Cause ◽  
Common Causes ◽  
Daily Function

Dementia is the term used to describe progressive impairment of thinking and memory that interferes with daily function. Dementia is not a specific disorder; rather, it is a condition with many causes. Alzheimer’s disease is the most common cause of dementia. Other common causes of dementia include vascular dementia, dementia with Lewy bodies, primary progressive aphasia which comes in the logopenic, semantic, and nonfluent/agrammatic variants, behavioral variant frontotemporal dementia, and normal pressure hydrocephalus. Primary care providers are able to diagnose most straightforward cases of dementia, whereas specialists such as neuropsychologists, neurologists, psychiatrists, and geriatricians may be needed when the diagnosis is not straightforward.

What is dementia?

2021 ◽  
pp. 3-10
Author(s):  
Andrew E. Budson ◽  
Maureen K. O’Connor
Keyword(s):  
Primary Care ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Primary Progressive Aphasia ◽  
Normal Pressure ◽  
Primary Care Providers ◽  
Care Providers ◽  
Common Cause ◽  
Common Causes ◽  
Daily Function

Dementia is the term used to describe progressive impairment of thinking and memory that interferes with daily function. Dementia is not a specific disorder; rather, it is a condition with many causes. Alzheimer’s disease is the most common cause of dementia. Other common causes of dementia include vascular dementia, dementia with Lewy bodies, primary progressive aphasia which comes in the logopenic, semantic, and nonfluent/agrammatic variants, behavioral variant frontotemporal dementia, and normal pressure hydrocephalus. Primary care providers are able to diagnose most straightforward cases of dementia, whereas specialists such as neuropsychologists, neurologists, psychiatrists, and geriatricians may be needed when the diagnosis is not straightforward.

scholarly journals TO STUDY THE INCIDENCE, ETIOLOGY AND CORRELATION BETWEEN SERUM AMYLASE LEVELS AND BALTHAZAR SCORE (SEVERITY) IN PATIENTS OF ACUTE PANCREATITIS AT TERTIARY CARE HOSPITAL

2020 ◽  
pp. 1-3
Author(s):  
Snehal N. Purandare ◽  
Aishwarya U. Chavan ◽  
Brijesh U. Patil
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Age Groups ◽  
Care Hospital ◽  
Normal Range ◽  
Female Ratio ◽  
Common Cause ◽  
Presenting Symptoms ◽  
Number Of Patients ◽  
The Mean

Acute pancreatitis is a heterogeneous disease ranging from minimal pancreatic inflammation seen in mild interstitial pancreatitis to extensive pancreatic necrosis and liquefaction of severe attacks. The incidence of acute pancreatitis is 33.3 per 100,000 population. Maximum number of patients with acute pancreatitis belong to the age groups of 26 – 35 years and 36- 45 years with 34.8% of cases in each of the mentioned age groups. The mean age of presentation was 39 years. Out of the 89 patients who were diagnosed with pancreatitis, only 5 patients were females while all others were males. The male to female ratio was 16.8: 1 with male preponderance. On presentation, all 89 patients (100%) had pain in abdomen, 89.9% of the cases had vomiting and 64% of the cases had radiating back pain as the presenting symptoms. Alcohol abuse was found to be the most common cause of pancreatitis isolated in 89.9% of the patients which explains the 16.8:1 male female ratio. The second most common cause was gallstone induced pancreatitis (9%) while idiopathic pancreatitis was found in 1.1% of the cases. None of the patients had other rare causes of pancreatitis amongst the miscellaneous category. The sensitivity of serum amylase was 84.3% while the specificity of serum amylase was 55.9%. For Balthazar score (inflammation) 1, 2, 3 the mean serum amylase value (U/L) was 696.5, 829.6 and 822.0 respectively. [Normal Range: 22 – 80U/L in our institute] For Balthazar score (necrosis) 0, 2, 4 the mean serum amylase value (U/L) was 738.1, 57.7 and 43 respectively. [Normal Range: 22 – 80U/L in our institute] As the Balthazar score (necrosis) increases, the value of serum amylase remains in the normal limits and does not increase suggesting an inverse correlation between the two.

Midodrine treatment in children with recurrent vasovagal syncope

2021 ◽  
pp. 1-5
Author(s):  
Denizhan Bagrul ◽  
Ibrahim Ece ◽  
Arzu Yılmaz ◽  
Fatih Atik ◽  
Ahmet Vedat Kavurt
Keyword(s):  
Conventional Treatment ◽  
Vasovagal Syncope ◽  
Pharmacological Treatments ◽  
Common Cause ◽  
Satisfactory Level ◽  
Treatment Dose ◽  
The Mean

Abstract Background: Vasovagal syncope is the most common cause of syncope in childhood and its treatment is not at a satisfactory level yet. We aimed to investigate patients who were diagnosed with vasovagal syncope, did not benefit from conventional treatment, received midodrine treatment, and to evaluate their response to midodrine treatment. Methods: Files of 24 patients who were diagnosed with recurrent vasovagal syncope, did not benefit from non-pharmacological treatments, and received midodrine treatment during June 2017–October 2019 were retrospectively analysed. Results: In total, 24 patients received a treatment dose of midodrine at 5 mg/day (2.5 mg BID) included in the study. The mean number of syncope was 5.75 ± 2.67 prior to treatment. Following treatment, the mean number of syncope was 0.42 ± 0.89. It was observed that syncope episodes did not recur in 17 patients, but it recurred in 4 out of 7 patients in the first 3 months of the treatment and did not recur in the following months. The episodes improved in two patients with an increase in the treatment dose, but the syncope episodes continued in only one patient. Conclusion: It was concluded that midodrine treatment was effective and safe in adolescents with recurrent vasovagal syncope.

scholarly journals Platelet counts during pregnancy in Chinese women

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Li-Xia Zhang ◽  
Ning Dong ◽  
Rui-Xia Yang ◽  
Ang Li ◽  
Xuan-Mei Luo ◽  
...  
Keyword(s):  
Chinese Women ◽  
Third Trimester ◽  
Bleeding Events ◽  
Common Cause ◽  
Platelet Counts ◽  
The Third ◽  
Uncomplicated Pregnancy ◽  
Gestational Thrombocytopenia ◽  
The Mean ◽  
Medical University

AbstractObjectivesGestational thrombocytopenia (GT) is the most common cause of thrombocytopenia during pregnancy. However, the occurrence and severity of thrombocytopenia throughout pregnancy in Chinese women are not fully defined.MethodsWe analyzed platelet counts in Chinese women who received prenatal care and/or delivered at the First Affiliated Hospital with Nanjing Medical University between January 2, 2018 and July 19, 2018 in China. These platelet counts were compared with those of nonpregnant women in the same study period.ResultsThe platelet counts of all women continued to decrease significantly each trimester (p < 0.0001). The mean platelet counts of the 818 women who had pregnancy-related complications were lower than those of the 796 women who had uncomplicated pregnancies during the third trimester (p = 0.047). At the time of delivery, platelet counts less than 150 × 109/L were more common in women with pregnancy-related complications than in women with uncomplicated pregnancy (26.7% vs. 19.7%, p = 0.03).ConclusionsPlatelet counts decrease throughout pregnancy in Chinese women and platelet counts less than 150 × 109/L were more common in women with pregnancy-related complications than in women with uncomplicated pregnancy. The pregnant women should be paid more attention for thrombocytopenia to avoid the occurrence of bleeding events.

Retroclival Epidural Hematomas

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 404-407 ◽  
Author(s):  
R. Shane Tubbs ◽  
Christoph J. Griessenauer ◽  
Todd Hankinson ◽  
Curtis Rozzelle ◽  
John C. Wellons ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Pediatric Patients ◽  
Motor Vehicle ◽  
Coma Scale ◽  
Presenting Symptoms ◽  
Cord Injury ◽  
The Mean

Abstract BACKGROUND Retroclival epidural hematomas (REDHs) are infrequently reported. To our knowledge, only 19 case reports exist in the literature. OBJECTIVE This study was performed to better elucidate this pathology. METHODS We prospectively collected data for all pediatric patients diagnosed with REDH from July 2006 through June 2009. Data included mechanism of injury, Glasgow Coma Scale score, neurological examination, treatment modality, and outcome. Magnetic resonance imaging was used to measure REDH dimensions. RESULTS Eight children were diagnosed with REDH, and the hematomas were secondary to motor vehicle–related trauma in all cases. The mean age of patients was 12 years (range 4–17 years). The mean REDH height (craniocaudal) was 4.0 cm, and the mean thickness (dorsoventral) was 1.0 cm. At presentation, the mean Glasgow Coma Scale score was 8 (range 3–14), and there was no correlation between hematoma size and presenting symptoms. Two patients died soon after injury, and 2 additional patients had atlanto-occipital dislocation that required surgical intervention. No patient underwent surgical evacuation of the REDH. The mean follow-up was 14 months. At most recent follow-up, 4 patients are neurologically intact, 1 patient has a complete spinal cord injury, and 1 patient has mild bilateral abducens nerve palsy. CONCLUSION To our knowledge, this study of 8 pediatric patients is the largest series of patients with REDH thus far reported. Based on our study, we found that REDH is likely to be underdiagnosed, atlanto-occipital dislocation should be considered in all cases of REDH, and many patients with REDH will have minimal long-term neurological injury.

Frequency, Predictors, and Outcome of Seizures in Patients With Myelomeningocele: Single-Center Retrospective Cohort Study

2021 ◽  
pp. 088307382110531
Author(s):  
Cemal Karakas ◽  
Emin Fidan ◽  
Kapil Arya ◽  
Troy Webber ◽  
Joan B. Cracco
Keyword(s):  
Good Prognosis ◽  
Cortical Atrophy ◽  
Seizure Freedom ◽  
Single Center ◽  
Seizure Onset ◽  
Shunt Procedure ◽  
History Of ◽  
The Mean

To determine the frequency, predictors, and outcomes of seizures in patients with myelomeningocele, we retrospectively analyzed the data from patients with myelomeningocele followed longitudinally at a single center from 1975 to 2013. We identified a total of 122 patients (61% female). The mean follow-up duration was 11.1 years (minimum-maximum = 0-34.5 years, SD = 8.8, median = 9.1 years). A total of 108 (88.5%) patients had hydrocephalus, and 98 (90.7%) of those patients required a ventriculoperitoneal shunt procedure. Twenty-four (19.7%) patients manifested with seizures, 23 of whom had hydrocephalus. The average age of seizure onset was 4.8 years (median 2 years of age). Falx dysgenesis ( P = .004), lumbar myelomeningocele ( P = .007), and cortical atrophy ( P = .028) were significantly associated with epileptic seizure development. The average seizure-free period at the last follow-up in patients with a history of myelomeningocele and seizures was 8.1 years. We conclude that myelomeningocele patients with seizures have an overall good prognosis with considerable long-term seizure freedom.

Difficulties in diagnosing atypical variants of Alzheimer’s disease

2021 ◽  
Vol 26 (5) ◽  
pp. 16-23
Author(s):  
A. A. Tappakhov ◽  
T. Ya. Nikolaeva ◽  
T. E. Popova ◽  
N. A. Shnayder
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Picture ◽  
Short Term Memory ◽  
Late Onset ◽  
Early Stage ◽  
Primary Progressive Aphasia ◽  
Cortical Atrophy ◽  
Posterior Cortical Atrophy ◽  
Short Term

Alzheimer’s disease (AD) is the most common cause of dementia in the population. Late onset AD has a classic clinical picture with short-term memory deficit, apraxia and agnosia. Patients with early-onset AD may have an atypical clinical picture which complicates diagnosis. Atypical AD variants include the logopenic variant of primary progressive aphasia, posterior cortical atrophy, behavioral, biparietal, and cortico-basal variants. These variants have pathomorphological signs similar to classical AD, but at an early stage they are characterized by focal atrophy which explains their clinical polymorphism. This article provides a review of the current literature on atypical types of AD and presents a clinical case of a 62-year-old patient in whom the disease debuted with prosopagnosia due to focal atrophy of the temporo-occipital regions of the non-dominant hemisphere.

Clinical Characteristic in Primary Progressive Aphasia in Relation to Alzheimer’s Disease Biomarkers

2021 ◽  
pp. 1-13
Author(s):  
Sung Hoon Kang ◽  
Hanna Cho ◽  
Jiho Shin ◽  
Hang-Rai Kim ◽  
Young Noh ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Language Impairment ◽  
Amyloid Β ◽  
Primary Progressive Aphasia ◽  
Cortical Atrophy ◽  
Clinical Feature ◽  
Progressive Aphasia ◽  
Disease Biomarkers ◽  
Primary Progressive

Background: Primary progressive aphasia (PPA) is associated with amyloid-β (Aβ) pathology. However, clinical feature of PPA based on Aβ positivity remains unclear. Objective: We aimed to assess the prevalence of Aβ positivity in patients with PPA and compare the clinical characteristics of patients with Aβ-positive (A+) and Aβ-negative (A–) PPA. Further, we applied Aβ and tau classification system (AT system) in patients with PPA for whom additional information of in vivo tau biomarker was available. Methods: We recruited 110 patients with PPA (41 semantic [svPPA], 27 non-fluent [nfvPPA], 32 logopenic [lvPPA], and 10 unclassified [ucPPA]) who underwent Aβ-PET imaging at multi centers. The extent of language impairment and cortical atrophy were compared between the A+ and A–PPA subgroups using general linear models. Results: The prevalence of Aβ positivity was highest in patients with lvPPA (81.3%), followed by ucPPA (60.0%), nfvPPA (18.5%), and svPPA (9.8%). The A+ PPA subgroup manifested cortical atrophy mainly in the left superior temporal/inferior parietal regions and had lower repetition scores compared to the A–PPA subgroup. Further, we observed that more than 90%(13/14) of the patients with A+ PPA had tau deposition. Conclusion: Our findings will help clinicians understand the patterns of language impairment and cortical atrophy in patients with PPA based on Aβ deposition. Considering that most of the A+ PPA patents are tau positive, understanding the influence of Alzheimer’s disease biomarkers on PPA might provide an opportunity for these patients to participate in clinical trials aimed for treating atypical Alzheimer’s disease.

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