Visual signs and symptoms in patients with the visual variant of Alzheimer disease.

BACKGROUND: Prominent visual symptoms can present in the visual variant of Alzheimer's disease (VVAD). Ophthalmologists have a significant role to play in the early diagnosis of VVAD. METHODS: We retrospectively reviewed the files of ten consecutive patients diagnosed with VVAD. All patients had a full neuro-ophthalmologic examination, a formal neurological and neuro-psychological testing, and cerebral MRI to confirm diagnosis. In addition, functional neuroimaging was obtained in seven patients. RESULTS: The common primary symptom at presentation with all patients was difficulty with near vision (reading difficulty n = 8, "visual blur" in near vision n = 2), and difficulty writing (n = 3). Following assessment, impaired reading and writing skills were evident in 9/10 and 8/10 patients respectively. Median distance visual acuity was 20/25 and at near the median visual acuity was J6. Partial homonymous visual field defect was detected in 80 % (8/10) of the patients. Color vision was impaired in all patients when tested with Ishihara pseudoisochromatic plates, but simple color naming was normal in 8/9 tested patients. Simultanagnosia was present in 8/10 patients. Vision dysfunction corresponded with cerebral MRI findings where parieto-occipital cortical atrophy was observed in all patients. PET scan (5 patients) or SPECT (2 patients) revealed parieto-occipital dysfunction (hypometabolism or hypoperfusion) in all 7 tested patients CONCLUSIONS: Visual difficulties are prominent in VVAD. Dyslexia, incomplete homonymous hemianopia, preserved color identification with abnormal color vision on Ishihara, and simultanagnosia were all symptoms observed frequently in this patient series. Ophthalmologists should be aware of the possibility of neurodegenerative disorders such as VVAD in patients with unexplained visual complaints, in particular reading difficulties

Penilaian Risiko K3 pada Proses Pabrikasi Menggunakan Metode Hazard Identification, Risk Assessment and Risk Control (HIRARC)

PT. Tri Jaya Teknik merupakan perusahaan pabrikasi yang selama tiga tahun masih mengalami kecelakaan kerja selama proses produksinya. Penelitian ini bertujuan mengidentifikasi potensi bahaya yang terjadi selama proses pabrikasi. Penelitian ini menggunakan metode HIRARC untuk mengidentifikasi, menilai dan mengendalikan risiko. Model HIRARC digunakan untuk mengidentifikasi bahaya primer dan sekunder yang mungkin terjadi pada kegiatan pekerjaan yang berdampak pada ancaman serius pada kegiatan operasi. Kegiatan pabrikasi pada PT. Tri Jaya Teknik teridentifikasi mempunyai 30 potensi risiko yang terjadi di proses stamping, trolley, milling, gerinda dan welding. Hasil penilaian menunjukkan 13,3% mempunyai tingkat risiko extreme, 30% high risk, 13,3% medium risk dan 43,34% low risk. Pengendalian risiko untuk pencegahan kecelakaan kerja dapat dilakukan dengan menggunakan di alat pelindung diri di lingkungan pabrik, rekayasa di setiap proses produksi untuk meminimalisir bahaya dan administrasi seperti standard operating procedure agar sesuai dengan standar yang sudah ditentukan perusahaan

Motor and Non-motor Features: Differences between Patients with Isolated Essential Tremor and Patients with Both Essential Tremor and Parkinson’s Disease

Background: Patients with essential tremor (ET) who develop Parkinson’s disease (ET->PD) may differ with respect to motor features (MFs) and non-motor features (NMFs) from patients with isolated ET. Few studies have assessed this issue. Methods: In this retrospective chart review, we analyzed data on MFs and NMFs of 175 patients, including 54 ET->PD and 121 ET, actively followed in the Athens University 1st Neurology Department. Results: Significantly more ET->PD than ET patients reported asymmetric tremor at ET onset (68.5% vs. 14.9%, pPD patients had head tremor (43.5% vs. 13.2%, pPD patients reported hearing impairment (65.3% vs. 28.3%, pPD than ET patients reported rapid eye movement behavior disorder (51.9% vs. 10.0%, p<0.001), constipation (67.9% vs. 36.4%, p<0.001), and olfactory dysfunction (83.3% vs. 36.4%, p<0.001). Discussion: The subset of ET->PD patients may have distinct MFs and NMFs that should be assessed further for the possible predictive value for the emergence of PD