Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months

Copyright \ua9 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.OBJECTIVE: This study aimed to quantify the trajectory and magnitude of change of the key clinical features and corresponding symptom domains of dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD), including global cognition, parkinsonism, recurrent visual hallucinations, cognitive fluctuations, and sleep disturbance. METHODS: One hundred sixteen patients with Lewy body dementia (DLB = 72, PDD = 44) underwent assessment at baseline and 3 and 6 months as part of a prospective multicenter randomized controlled trial. Linear mixed models were constructed for core outcome measures using the Mini-Mental State Examination (MMSE), motor section of the Unified Parkinson\u27s Disease Rating Scale (UPDRS-III), Dementia Cognitive Fluctuations Scale (DCFS), and Neuropsychiatric Inventory (NPI). RESULTS: Within the time frame of our study (6 months), we were able to identify a significant cognitive decline of 1.3 points on the MMSE (p = 0.002) and significant worsening of motor parkinsonism with an increase in UPDRS-III score of 3.2 points (p = 0.018). Fluctuation severity also increased using the DCFS with a 6-month change in score of 1.3 points (p = 0.001). Uniquely, a signal for increased severity of sleep symptoms of 1.2 points (NPI-sleep) was also detectable (p = 0.04). Significant changes in neuropsychiatric symptoms were not detected. There was no difference in rates of change of scores between DLB and PDD. DISCUSSION: Clinically significant rates of change in core clinical features can be detected and quantified in Lewy body dementia over a relatively short period (6 months) using common clinical instruments and thus may be useful as clinical endpoints for therapeutic trials of disease-modifying and symptomatic agents

Temperature and velocity field measurements of pool boiling using two-colour laser-induced fluorescence, infrared thermometry and particle image velocimetry

We study nucleate pool boiling in water at saturation temperature and ambient pressure under low heat fluxes. A combination of high-speed and spatially-resolved diagnostic tools are developed and applied to provide detailed insight into the flow and heat transfer mechanisms during bubble life cycle. Two fluorescent dyes with non-overlapping spectra are seeded into the water and are excited by a Nd:YLF laser sheet at 527 nm. A two-colour laser-induced fluorescence method is employed to individually track the fluorescence of each dye by connecting two cameras, equipped with separate optical filters, to a beamsplitter and a lens. Tracer particles are also introduced in the water to perform simultaneous particle image velocimetry measurements. Finally, synchronised high-speed infrared thermometry is conducted to acquire the surface temperature field over the heater. The links between the interfacial/bubble dynamics, flow and heat transfer are investigated. Superheated liquid from the thermal boundary layer adjacent to the heater is displaced upwards, due to the growth and departure of the bubbles. Two counteracting vortices form on each side of the bubbles during their departure and rise, which contribute to the scavenging and mixing of the bulk water, resulting in a trail of superheated liquid below them

Experimental investigation of bubble nucleation, growth and departure using synchornized IR thermometry, two-colour LIF and PIV

Boiling is a very effectiveheat removal process exploited in many applications, from electronic devicesto nuclear reactors. However, the physical mechanisms involved in this process are not fully understood yet, due toits complexity, whicharises from the many interacting sub-processes involved in the nucleation, growth, and detachment of isolated bubbles. Here, we present the methodology and initialresults from an experimental investigation aimed at elucidating and quantifying the mechanisms involved in a bubble life cycle (fromnucleation until departure). Towards this aim, we use synchronized high-speed infrared(IR)thermometry, ratiometric two-color laser-induced fluorescence (2cLIF) and particle image velocimetry (PIV). Infrared thermometry is used to measure the time-dependent temperature and heat flux distributions overthe boilingsurface, which are usefulto quantify the transfer of energy associated with the evaporation of the micro-layer. Two-color laser-induced fluorescence is used to measure the time-dependent temperature distribution in the liquid phase. Particle image velocimetry is employedto measure the velocity field around the bubble, necessary to elucidate the bubble growth and departure mechanisms. The investigation also revealsother fundamental heat transferaspects such as the dynamics of the near-wall superheated liquid layer, the mixing effect produced by bubble growth and departure, as well as convection effects around the bubble

Otite externa difusa aguda: um estudo prospectivo no verão do Rio de Janeiro Acute diffuse external otitis: a prospective study in Rio de Janeiro's summer

A Otite Externa Aguda é uma doença extremamente comum em países tropicais, especialmente no verão. Vários fatores predisponentes são identificáveis e o quadro clínico pode ser bastante variado, principalmente com relação à intensidade da otalgia. OBJETIVO: Avaliar, através de um estudo prospectivo no maior hospital de Emergências do Rio de Janeiro, a incidência e as características da otite externa no período de verão. FORMA DE ESTUDO: Estudo clínico com coorte transversal. MATERIAL E MÉTODO: 391 pacientes com otite externa atendidos no Serviço de ORL do Hospital Souza Aguiar foram avaliados em uma série de parâmetros clínicos e de tratamento, incluindo análise de possíveis fatores predisponentes. RESULTADOS: Os principais sintomas referidos foram otalgia, otorréia discreta e plenitude auricular. Os principais fatores predisponentes foram banho de mar e piscina e uso de cotonetes. CONCLUSÃO: A otite externa aguda é uma doença extremamente comum em países tropicais, especialmente no verão. A possível contaminação da água de praias e piscinas, embora descartada por vários autores como fatores predisponentes, pode ter alguma influência na sua patogênese.<br>The acute external otitis is a very common disease in tropical countries, especially in summer. There are many predisposing factors and clinical features may vary, particularly the pain's severity. AIM: Evaluate, with a prospective study in Rio de Janeiro's largest Urgencies Hospital, the incidence and characteristics of the acute external otitis in summer. STUDY DESIGN: Clinical study with transversal cohort. MATERIAL AND METH: 391 patients with acute external otitis in Souza Aguiar Hospital were evaluated in several clinical and treatment parameters, including predisposing factors analysis. RESULTS Pain, moderate ear discharge and sensation of "full ear" were the most common complaints. Sea and pool baths and the use of ear sticks were the most common predisposing factors. CONCLUSION: The acute external otitis is a very common disease in tropical countries, especially in summer. Sea and pools water contamination, although rejected by many authors as a predisposing factor, may have a role the patogenesis of the acute diffuse external otitis