Recovery from Transient Global Amnesia Following Restoration of Hippocampal and Fronto–Cingulate Perfusion

A patient who suffered a transient global amnesia (TGA) attack underwent regional cerebral blood flow (rCBF) SPECT imaging and neuropsychological testing in the acute phase, after one month and after one year. Neuropsychological testing in the acute phase showed a pattern of anterograde and retrograde amnesia, whereas memory was within age normal limits at follow up. SPECT data were analysed with a within subject comparison and also compared with those of a group of healthy controls. Within subject comparison between the one month follow up and the acute phase detected increases in rCBF in the hippocampus bilaterally; further rCBF increases in the right hippocampus were detected after one year. Compared to controls, significant hypoperfusion was found in the right precentral, cingulate and medial frontal gyri in the acute phase; after one month significant hypoperfusion was detected in the right precentral and cingulate gyri and the left postcentral gyrus; after one year no significant hypoperfusion appeared. The restoration of memory was paralleled by rCBF increases in the hippocampus and fronto-limbic-parietal cortex; after one year neither significant rCBF differences nor cognitive deficits were detectable. In conclusion, these data indicate that TGA had no long lasting cognitive and neural alterations in this patient

Degenerative Jargon Aphasia: Unusual Progression of Logopenic/Phonological Progressive Aphasia?

Primary progressive aphasia (PPA) corresponds to the gradual degeneration of language which can occur as nonfluent/agrammatic PPA, semantic variant PPA or logopenic variant PPA. We describe the clinical evolution of a patient with PPA presenting jargon aphasia as a late feature. At the onset of the disease (ten years ago) the patient showed anomia and executive deficits, followed later on by phonemic paraphasias and neologisms, deficits in verbal short-term memory, naming, verbal and semantic fluency. At recent follow-up the patient developed an unintelligible jargon with both semantic and neologistic errors, as well as with severe deficit of comprehension which precluded any further neuropsychological assessment. Compared to healthy controls, FDG-PET showed a hypometabolism in the left angular and middle temporal gyri, precuneus, caudate, posterior cingulate, middle frontal gyrus, and bilaterally in the superior temporal and inferior frontal gyri. The clinical and neuroimaging profile seems to support the hypothesis that the patient developed a late feature of logopenic variant PPA characterized by jargonaphasia and associated with superior temporal and parietal dysfunction

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

A method for measuring individual research productivity in hospitals: Development and feasibility

BACKGROUND: Research capacity is a prerequisite for any health care institution intending to provide high-quality care, yet, few clinicians engage in research, and their work is rarely recognized. To make research an institutional activity, it could be helpful to measure health care professionals’ research performance. However, a comprehensive approach to do this is lacking. METHODS: We conducted a literature analysis to determine how best to assess research performance. Our method was not restricted to bibliometric and citation parameters, as is usually the case, but also including “hidden” activities, generally not considered in research performance evaluations. RESULTS: A set of 12 easily retrievable indicators was used and corresponding points assigned according to a weighting system intended to reflect the effort estimated to perform each activity. We observed a highly skewed score distribution, with a minority of health care professionals performing well across the indicators. The highest score was recorded for scientific papers (768/1098 points, 70 %). Twenty percent of researchers at our institution generated 50 % of points. CONCLUSIONS: We develop a simple method for measuring research performance, which could be rapidly implemented in health care institutions. It is hoped that the proposed method might be useful for promoting research and guiding resource allocation, although further evaluations are needed to confirm the method’s utility. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-1130-7) contains supplementary material, which is available to authorized users

Additional file 1: of A method for measuring individual research productivity in hospitals: development and feasibility

Questionnaire to record participation in resarch activities. (DOC 32 kb

Effect of iterative reconstruction on image quality of low-dose chest computed tomography

AIM: To assess quality and radiologists' preference of low-dose computed tomography (LDCT) reconstructed with filtered back projection (FBP) or Iterative Reconstruction. METHODS: Thin-section LDCTs (1-mm thick contiguous images; 120 kVp; 30 mAs) of 38 consecutive unselected patients, evaluated for various clinical indications, were reconstructed by four different reconstruction algorithms: FBP and Sinogram-AFfirmed Iterative Reconstruction (SAFIRE) with three different strengths, from 2 to 4 (i.e. S2, S3, S4). The image noise was recorded. Two thoracic radiologists visually compared both anatomic structures (interlobular septa, lung fissures, centrilobular artery, bronchial wall, and small vessels) and lung abnormalities (intralobular reticular opacities, nodules, emphysema, cystic lung disease, decreased-attenuation areas related to constrictive obliterans bronchiolitis, patchy ground-glass opacity, consolidation, and bronchiectasis) using a qualitative four-point scale grading system of the image quality. RESULTS: A lower amount of noise was recorded for LDCTs reformatted with any SAFIRE algorithm, as compared to FBP (P < 0.0001). The noise levels decreased as the SAFIRE strength increased from S2 to S4. The visual score of the subsegmental/segmental bronchial wall was greater for the FBP datasets compared to any SAFIRE dataset (P < 0.0001 for reviewer 1; P < 0.02 for reviewer 2). The decreased lung attenuation pattern score was lower on the S4 images for one reviewer, as compared to the other LDCT datasets (P = 0.003). No other differences in terms of radiologists' preference were recorded among FBP, S2, S3, and S4. Interobserver agreement was moderate only for fissures and bronchial wall, and good to excellent for the remainders. CONCLUSION: Iterative reconstructions showed lower image noise but did not provide any real improvement for the radiologists' evaluation of thin-section LDCT of the lung

Lung dual energy CT: Impact of different technological solutions on quantitative analysis

Purpose: To evaluated the accuracy of spectral parameters quantification of four different CT scanners in dual energy examinations of the lung using a dedicated phantom. Method: Measurements were made with different technologies of the same vendor: one dual source CT scanner (DSCT), one TwinBeam (i.e. split filter) and two sequential acquisition single source scanners (SSCT). Angular separation of Calcium and Iodine signals were calculated from scatter plots of low-kVp versus high-kVp HUs. Electron density (ρe), effective atomic number (Zeff) and Iodine concentration (Iconc) were measured using Syngo.via software. Accuracy (A) of ρe, Zeff and Iconc was evaluated as the absolute percentage difference (D%) between reference values and measured ones, while precision (P) was evaluated as the variability σ obtained by repeating the measurement with different acquisition/reconstruction settings. Results: Angular separation was significantly larger for DSCT (α&nbsp;=&nbsp;9.7°) and for sequential SSCT (α&nbsp;=&nbsp;9.9°) systems. TwinBeam was less performing in material separation (α&nbsp;=&nbsp;5.0°). The lowest average A was observed for TwinBeam (Aρe&nbsp;=&nbsp;[4.7&nbsp;±&nbsp;1.0], AZ&nbsp;=&nbsp;[9.1&nbsp;±&nbsp;3.1], AIconc&nbsp;=&nbsp;[19.4&nbsp;±&nbsp;4.4]), while the best average A was obtained for Flash (Aρe&nbsp;=&nbsp;[1.8&nbsp;±&nbsp;0.4], AZ&nbsp;=&nbsp;[3.5&nbsp;±&nbsp;0.7], AIconc&nbsp;=&nbsp;[7.3&nbsp;±&nbsp;1.8]). TwinBeam presented inferior average P (Pρe&nbsp;=&nbsp;[0.6&nbsp;±&nbsp;0.1], PZ&nbsp;=&nbsp;[1.1&nbsp;±&nbsp;0.2], PIconc&nbsp;=&nbsp;[10.9&nbsp;±&nbsp;4.9]), while other technologies demonstrate a comparable average. Conclusions: Different technologies performed material separation and spectral parameter quantification with different degrees of accuracy and precision. DSCT performed better while TwinBeam demonstrated not excellent performance. Iodine concentration measurements exhibited high variability due to low Iodine absolute content in lung nodules, thus limiting its clinical usefulness in pulmonary applications