Difficulties in the diagnosis of four repeats (4R) tauopathic parkinsonian syndromes.

Corticobasal Degeneration Degeneration (CBD) and Progressive Supranuclear Palsy (PSP) are types of four repeats (4R) tauopathies, which are associated to parkinsonian syndromes. The aim of the work is to analyze cases of patients of the Department of Neurology, overlapping of syndromes related to both pathologies and to show that most likely CBS and PSP are not lineary related to their commonly associated syndromes i.e. adequately corticobasal syndromes and progressive supranuclear palsy syndromes. In the context of each patient factors in favor of most likely CBS, PSP or both diseases are discussed and analyzed using contemporary criteria. This work discusses multidimensional aspect of the examination of five patient aged 64 to 83 - 4 females and 1 male with 4R tauopathies and difficulties in distinguishing both diseases. The duration of the disease varied from 1 to 5 years. Each patient after neurological examination was assessed using magnetic resonance imaging (MRI) and psychological test. Examination of all patients was extended using single photon emission computer tomography (SPECT) to reveal the usefulness of this tool in differentiation of diseases was done. The outcome of this examination was verified with prior clinical manifestation of patients and morphological abnormalities in magnetic resonance imaging. Autopsies were not conducted.

Cognitive impairment after appropriate implantable cardioverter-defibrillator therapy for ventricular fibrillation.

BACKGROUND: Short periods of cerebral ischaemia during ventricular defibrillation testing may be associated with neuropsychological impairment. However, the impact of out-of-hospital ventricular fibrillation (VF) converted by implantable cardioverter-defibrillator (ICD) shock on cognitive functioning is unknown. AIM: To assess the impact of out-of-hospital VF converted by ICD shock on cognitive functioning. METHODS: The study included 52 primary prevention ICD recipients. Patients with a history of stroke or other neurological impairment, previous head injury and individuals unable to see or speak to complete neuropsychological tests were not included.Initially, a Mini-Mental State Examination was performed in all patients and one patient with a result below 24 points was excluded from the study. The cognitive battery consisted of four tests (six measurements): 1) the Digit Span subtest of Wechsler Adult Intelligence Scale-Revised; 2) the Digit Symbol subtest of Wechsler Adult Intelligence Scale-Revised; 3) the Halstead-Reitan Trail-Making Test A and B; and 4) the Ruff Figural Fluency Test. RESULTS: The mean time from ICD implantation to cognitive assessment was 26 months. During this period, 15 appropriate shocks for VF were observed in seven (14%) patients. The patients with appropriate ICD therapy were significantly worse in two out of the six neuropsychological measurements and had a significantly lower aggregate result. In multivariate linear regression analysis, defibrillation therapy was an independent factor of poor cognitive functioning, along with age and education. CONCLUSIONS: Short periods of out-of-hospital VF converted by ICD are associated with cognitive impairment in the recipients of primary prevention ICD.

[Relationship between peritoneal equilibration test and surface tension of peritoneal effluent in CAPD patients]. / Zaleznosci miedzy wartoscia testu równowazenia otrzewnowego (PET) a napieciem powierzchniowym dializatu u chorych leczonych ciagla ambulatoryjna dializa otrzewnowa.

Surface phenomena resulting from interactions between molecules occur commonly in nature. Peritoneal effluent is a mixture of organic and inorganic substances both macro- and micromolecular. Surfactants present in dialysate affect its surface properties. Among them are: proteins, phospholipids, fatty acids. Our aim in this study was to investigate relationships between peritoneal membrane solute transport characteristics and surface tension of peritoneal effluent. The study was conducted in 40 CAPD patients who were stable, without peritonitis (24 M, 16F), age 51.5 +/- 15.8 (range 30-79) mean CAPD duration 26.4 +/- 20.6 months (range 4-72). Standard peritoneal equilibration test (sPET) was done in all patients. Dialysate surface tension (ST) values after 4 hours dewell were determined using Wilhelmy Plate method. Mean ST values of individual dialysate sample based on 10 measurements were calculated. According to the PET values patients were divided into two groups: group 1 (high/high average transporters, n = 26) and group 2 (low average/low transporters, n = 14). Patients in group 1 had significantly lower ST of dialysate than patients in group 2 (51.2 +/- 4.8 vs 57.9 +/- 1.4 mN/m), p<0.01. The lowest values of ST (48.5 +/- 5 mN/m) were found in patients classified as high transporters (n = 8). Correlation's: significant negative correlation was found between ST and D4/P4 for creatinine (r = -0.45, p<0.005) and significant positive correlation between ST and D4/DO for glucose (r = 0.48, p = 0.003). We conclude that there are significant relationships between peritoneal transport status and surface tension of peritoneal effluent. High transporters have significantly higher concentrations of surfactants in dialysis effluent.