Acute amnestic syndrome in fornix lesions: a systematic review of reported cases with a focus on differential diagnosis

IntroductionAcute amnestic syndrome is an uncommon clinical presentation of neurological disease. Differential diagnosis encompasses several syndromes including Wernicke-Korsakoff and transient global amnesia (TGA). Structural lesions of the fornix account for a minority of cases of acute amnestic syndromes. Etiology varies from iatrogenic injury to ischemic, inflammatory, or neoplastic lesions. A prompt diagnosis of the underlying pathology is essential but challenging. The aim of this review is to systematically review the existing literature regarding cases of acute amnestic syndrome associated with non-iatrogenic lesions of the fornix.MethodsWe performed a systematic literature search on PubMed, Scopus, and Web of Science up to September 2023 to identify case reports and case series of patients with amnestic syndrome due to fornix lesions. The systematic review was conducted according to PRISMA guidelines. The research was limited to articles written in English. Cases of fornix damage directly ascribable to a surgical procedure were excluded.ResultsA total of 52 publications reporting 55 cases were included in the review. Focusing on acute/subacute onset, vascular etiology was highly prevalent, being responsible for 78% of cases, 40/55 (74%) of which were due to acute ischemic stroke. The amnestic syndrome was characterized by anterograde amnesia in all patients, associated with retrograde amnesia in 27% of cases. Amnesia was an isolated presentation in most cases. Up to two thirds of patients had persistent memory deficits of any severity at follow-up.DiscussionAcute amnestic syndrome can be rarely caused by fornix lesions. In most cases of acute/subacute presentation, the etiology is ischemic stroke, mainly caused by strokes involving the subcallosal artery territory. The differential diagnosis is challenging and a distinction from common mimics is often difficult on a clinical basis. A high index of suspicion should be maintained to avoid misdiagnosis and provide adequate acute treatment to patients with time-dependent disease, also employing advanced neuroimaging. More research is needed to better understand the outcome and identify prognostic factors in patients with amnestic syndrome due to fornix lesions

Acute amnestic syndrome in fornix lesions: a systematic review of reported cases with a focus on differential diagnosis

Introduction: Acute amnestic syndrome is an uncommon clinical presentation of neurological disease. Differential diagnosis encompasses several syndromes including Wernicke-Korsakoff and transient global amnesia (TGA). Structural lesions of the fornix account for a minority of cases of acute amnestic syndromes. Etiology varies from iatrogenic injury to ischemic, inflammatory, or neoplastic lesions. A prompt diagnosis of the underlying pathology is essential but challenging. The aim of this review is to systematically review the existing literature regarding cases of acute amnestic syndrome associated with non iatrogenic lesions of the fornix. Methods: We performed a systematic literature search on PubMed, Scopus, and Web of Science up to September 2023 to identify case reports and case series of patients with amnestic syndrome due to fornix lesions. The systematic review was conducted according to PRISMA guidelines. The research was limited to articles written in English. Cases of fornix damage directly ascribable to a surgical procedure were excluded. Results: A total of 52 publications reporting 55 cases were included in the review. Focusing on acute/subacute onset, vascular etiology was highly prevalent, being responsible for 78% of cases, 40/55 (74%) of which were due to acute ischemic stroke. The amnestic syndrome was characterized by anterograde amnesia in all patients, associated with retrograde amnesia in 27% of cases. Amnesia was an isolated presentation in most cases. Up to two thirds of patients had persistent memory deficits of any severity at follow-up. Discussion: Acute amnestic syndrome can be rarely caused by fornix lesions. In most cases of acute/subacute presentation, the etiology is ischemic stroke, mainly caused by strokes involving the subcallosal artery territory. The differential diagnosis is challenging and a distinction from common mimics is often difficult on a clinical basis. A high index of suspicion should be maintained to avoid misdiagnosis and provide adequate acute treatment to patients with time dependent disease, also employing advanced neuroimaging. More research is needed to better understand the outcome and identify prognostic factors in patients with amnestic syndrome due to fornix lesions

Risk assessment of bottom ash from fuel oil power plant of Italy: mineralogical, chemical and leaching characterization

tom ash samples derived from an oil power plant located in Southern Italy. To achieve this purpose, the mineralogical and chemical properties of representative bottom ash samples were investigated through the integrated employment of different analytical techniques, i.e., X-ray powder diffraction, scanning electron microscopy, X-ray fluorescence and atomic absorption spectrometry. The obtained experimental results show that quartz, alunogen, rhomboclase and potassium hydrogen silicate are the major crystalline phases of all the analyzed samples. Furthermore, the revealed main ash constituents are SiO2 and SO3, with low contents of Fe2O3 and Al2O3, and little amounts of CaO, Na2O, K2O, MgO, P2O5 and TiO2. Among the trace elements, very high amounts of heavy metals, i.e., V, Cr, Ni, La, Pb and Mo, were detected. The comparison of the obtained heavy metal abundance data with those reported in the literature highlights significant differences. Leaching test evidenced V, Ni and Cr values that make these ashes a potential contamination source for groundwater quality and for soil, nearby the ash disposal landfills area. All the obtained findings show that these materials are highly harmful for the human health, with a greater extent for the heavy metal concentrations.Published2176A. Geochimica per l'ambiente e geologia medicaJCR Journa

Traceability of Protected Geographical Indication (PGI) Interdonato lemon pulps by chemometric analysis of the mineral composition

In the last years, element content has been used as geographical tracer to determine the provenance of food. In the present work the content of 19 minerals (K, Ca, Mg, Na, Fe, Zn, B, Cu, Al, Mn, Ni, Cr, Pb, Co, As, Se, Cd, Sb and V) and 13 lanthanide elements (La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm and Lu) in Protect Geographical Indication (PGI) Interdonato lemon Messina (Italy) and non-PGI Turkish lemon pulps was evaluated by ICP-MS. The collected data were used to discriminate geographical origin of lemon samples (PGI or non-PGI) through statistical analyses. The discrimination between Italian and Turkish lemons was achieved by Principal Component Analysis (PCA) and also by Canonical Discriminant Analysis (CDA). The results indicate that the 100% of total samples were correctly classified. The present study suggests that it is possible to relate lemons to their geographical origins, representing a necessary condition for traceability of these peculiar products. Unfortunately, Italian and Turkish lemon pulps cannot be considered “rich in” or “source of” analyzed minerals. However, these fruits can be considered safe for their low content in toxic elements