Computed tomography assessment of brain atrophy in centenarians

The aim of our study was to compare the degree of brain atrophy in centenarians and in seniors 70–99 years old. The study group consisted of 23 patients aged 100–106 years. The control group consisted of 90 patients, 30 in each age subgroup 90–99, 80–89, 70–79. In all the patients, the brain atrophy linear parameters were measured on computed tomography scans, in relation to both “subcortical atrophy”, evaluated as progressive widening of the ventricular system, and “cortical atrophy”, defined as widening of subarachnoid space. Secondary indices based on the parameters were calculated. Correlations between the above parameters/indices and age were tested. Significantly different values between the centenarians and the control group were found in the brain atrophy parameters: A, B, C, E, FI, ICR, ICL, SW, CFW, F/A ‘frontal horn index’, A/G ‘Evans index’, D/A ‘ventricular index’, H/E ‘cella media Schiersmann index’, A+B ‘Huckman number’. Correlations between parameter/index and age were found for: A, B, C, FI, ICR, ICL, SW, F/A ‘frontal horn index’, A/G ‘Evans index’, D/A ‘ventricular index’, H/E ‘cella media Schiersmann index’, A+B ‘Huckman number’. Brain atrophy associated with aging is a continuously advancing process, affecting centenarians even more than people before the “magic” threshold of 100 years.centenariansbrain atrophycomputed tomograph

Ischemic and non-ischemic patterns of late gadolinium enhancement in heart failure with reduced ejection fraction

Background: Late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) may revealmyocardial fibrosis which is associated with adverse clinical outcomes in patients undergoing implantablecardioverter-defibrillator (ICD) placement. At the same time, transmural LGE in the posterolateral wall isrelated to nonresponse to conventional cardiac resynchronization therapy (CRT). Herein, the aim was toassess the presence and determinants of LGE in CMR in heart failure (HF) with reduced ejection fraction.Methods: Sixty-seven patients were included (17.9% female, aged 45 [29–60] years), who underwentLGE-CMR and had left ventricular ejection fraction (LVEF) as determined by echocardiography.Results: In HF patients with LVEF ≤ 35% (n = 29), ischemic and non-ischemic patterns of LGE wereobserved in 51.7% and 34.5% of patients, respectively. In controls (n = 38), these patterns were noted in23.7% and 42.1% of patients, respectively. HF patients with LVEF ≤ 35% and transmural LGE in theposterolateral wall (31.0%) were characterized by older age, coronary artery disease (CAD) and previousmyocardial infarction (MI) (61 ± 6 vs. 49 ± 16 years, p = 0.008, 100% vs. 40%, p = 0.003 and 78%vs. 25%, p = 0.014, respectively). In patients with LVEF ≤ 35%, LGE of any type, diagnosed in 86.2%of patients, was associated with CAD (68% vs. 0%, p = 0.02), while only trends were observed for itsassociation with older age and previous MI (p = 0.08 and p = 0.12, respectively).Conclusions: Among HF patients with LVEF ≤ 35%, clinical factors including older age, CAD, andprevious MI are associated with transmural LGE in the posterolateral wall, while CAD is associated with LGE. This data may have potential implications for planning ICD and CRT placement procedures

Electrocardiography and cardiac magnetic resonance imaging in the detection of left ventricular hypertrophy : the impact of indexing methods

Background: Discrepancies between increased left ventricular mass (LVM) and electrocardiographic (ECG) criteria for the diagnosis of left ventricular hypertrophy (LVH) are described in the literature. Aims: This study aimed to evaluate the usefulness of ECG criteria in the diagnosis of LVH, as determined by cardiac magnetic resonance (CMR) imaging, using various LVM indexing methods. Methods: We included 53 patients who underwent CMR imaging and had electrocardiograms of appropriate quality available in their medical records. The majority of the study patients had cardiovascular diseases. We defined CMR‑LVH as increased LVM, also assessed after LVM indexing to body surface area (LVM/BSA), height1.7, height2.7, or as the percentage of predicted LVM (%pLVM). To determine ECG‑LVH, 10 different ECG-LVH criteria were used. Results: The prevalence of CMR‑LVH ranged from 11% (for %pLVM) to 72% (for LVM/BSA). At the same time, for a single criterion, the prevalence of ECG‑LVH ranged between 1.9% (for R wave amplitude in lead V5 / V6 greater than 2.6 mV, Sokolow–Lyon product, and Gubner–Ungerleider criterion) and 45.3% (for Peguero–Lo Presti criterion), showing high sensitivity, from 55.3% (95% CI, 38.3–71.4) to 100% (95% CI, 54.1–100). The sensitivity of ECG‑LVH criteria when all criteria were applied together ranged from 57.9% (95% CI, 40.8–73.7) to 100% (95% CI, 63.1–100). The best performance regarding the endpoint of CMR‑LVH diagnosis after LVM indexing was achieved by the Peguero–Lo Presti and Cornell criteria (area under the curve, 0.621–0.876; P, 0.001–0.17). Conclusions: Thediagnosis of LVH strongly depends on ECG- and CMR‑based definitions. ThePeguero–Lo Presti criterion and the Cornell criteria, which are sex‑specific, may provide the highest level of diagnostic accuracy and should be considered when screening patients with cardiovascular diseases for LVH

Realizacja i użytkowanie sieci PACS w zakładzie radiologii : doświadczenia własne

Background: DICOM created a common software platform enabling communication between devices from different vendors. This allows the creation of a PACS (Picture Archiving and Communication System) - a hospital network of imaging modalities, graphics workstations, film printers, and archiving devices. The aim of this study was to show the practical aspects of using a heterogeneous PACS, composed of equipment from several vendors. Both advantages and problems in the cooperation of theoretically "DICOM compatible" devices are presented. Material/Methods: A heterogeneous PACS was gradually created in our department between 1998 and 2003, currently consisting o f a Siemens CT multi-row scanner, a GE MRI scanner, a GE rotational angiograph, Siemens, GE, Marconi, and eFilm Medical graphics workstations, and Agfa thermal printers. DICOM 3.0 was used as a common protocol and the 100 Mb Ethernet as the hardware solution. Connectivity and interoperability in such a system were tested. Results: Using the DICOM protocol, it was possible to transfer images from the modality of one vendor to the graphics workstation of another vendor and then use sophisticated software for image processing. It was also possible to use storage devices such as CD recorders for images from modalities without a built-in storage option. In spite o f theoretical DICOM compatibility, in some cases it was not possible to achieve correct communication in practice. Conclusions: DICOM enables the gradual creation of a PACS with devices from different vendors, thus reducing implementation costs. Using a PACS, many different imaging modalities may use the same graphic workstations and digital printers. Usually one could expect full compatibility o f all DICOM devices; however, in practice cooperation is sometimes limited or erroneous, reducing the benefits of the standard. Archiving data on CD-ROMs is a solution which greatly reduces the operational costs of a radiology department

Oxidative-antioxidant imbalance and impaired glucose metabolism in schizophrenia

Schizophrenia is a neurodevelopmental disorder featuring chronic, complex neuropsychiatric features. The etiology and pathogenesis of schizophrenia are not fully understood. Oxidative-antioxidant imbalance is a potential determinant of schizophrenia. Oxidative, nitrosative, or sulfuric damage to enzymes of glycolysis and tricarboxylic acid cycle, as well as calcium transport and ATP biosynthesis might cause impaired bioenergetics function in the brain. This could explain the initial symptoms, such as the first psychotic episode and mild cognitive impairment. Another concept of the etiopathogenesis of schizophrenia is associated with impaired glucose metabolism and insulin resistance with the activation of the mTOR mitochondrial pathway, which may contribute to impaired neuronal development. Consequently, cognitive processes requiring ATP are compromised and dysfunctions in synaptic transmission lead to neuronal death, preceding changes in key brain areas. This review summarizes the role and mutual interactions of oxidative damage and impaired glucose metabolism as key factors affecting metabolic complications in schizophrenia. These observations may be a premise for novel potential therapeutic targets that will delay not only the onset of first symptoms but also the progression of schizophrenia and its complications

Differences in sweet taste perception and its association with the "Streptococcus mutans" cariogenic profile in preschool children with caries

The aim of the study was to verify the hypothesis about differences in sweet taste perception in the group of preschool children with and without caries, and to determine its relationship with cariogenic microbiota and the frequency of sweets consumption in children. The study group included of 63 children aged 2–6 years: 32 with caries and 31 without caries. The study consisted of collecting questionnaire data and assessment of dental status using the decayed, missing, filled in primary teeth index (dmft) and the International Caries Detection and Assessment System (ICDAS II). The evaluation of sweet taste perception was carried out using a specific method that simultaneously assessed the level of taste preferences and the sensitivity threshold for a given taste. The microbiological analysis consisted of the assessment of the quantitative and qualitative compositions of the oral microbiota of the examined children. The sweet taste perception of children with caries was characterized by a lower susceptibility to sucrose (the preferred sucrose solution concentration was >4 g/L) compared to children without caries (in the range ≤ 4 g/L, p = 0.0015, chi-square test). A similar relationship was also observed for frequent snacking between meals (p = 0.0038, chi-square test). The analysis of studied variables showed the existence of a strong positive correlation between the perception of sweet taste and the occurrence and intensity of the cariogenic process (p = 0.007 for dmft; and p = 0.012 for ICDAS II), as well as the frequency of consuming sweets (p ≤ 0.001 for frequent and repeated consumption of sweets during the day, Spearman test) in children with caries. Additionally, children with an elevated sucrose taste threshold were more than 10-times more likely to develop S. mutans presence (OR = 10.21; 95% CI 3.11–33.44). The results of this study suggest the future use of taste preferences in children as a diagnostic tool for the early detection of increased susceptibility to caries through microbial dysbiosis towards specific species of microorganisms