Effect of age, ethnicity, sex, cognitive status and APOE genotype on amyloid load and the threshold for amyloid positivity.

The threshold for amyloid positivity by visual assessment on PET has been validated by comparison to amyloid load measured histopathologically and biochemically at post mortem. As such, it is now feasible to use qualitative visual assessment of amyloid positivity as an in-vivo gold standard to determine those factors which can modify the quantitative threshold for amyloid positivity. We calculated quantitative amyloid load, measured as Standardized Uptake Value Ratios (SUVRs) using [18-F]florbetaben PET scans, for 159 Hispanic and non-Hispanic participants, who had been classified clinically as Cognitively Normal (CN), Mild Cognitive Impairment (MCI) or Dementia (DEM). PET scans were visually rated as amyloid positive (A+) or negative (A-), and these judgments were used as the gold standard with which to determine (using ROC analyses) the SUVR threshold for amyloid positivity considering factors such as age, ethnicity (Hispanic versus non-Hispanic), gender, cognitive status, and apolipoprotein E ε4 carrier status. Visually rated scans were A+ for 11% of CN, 39.0% of MCI and 70% of DEM participants. The optimal SUVR threshold for A+ among all participants was 1.42 (sensitivity = 94%; specificity = 92.5%), but this quantitative threshold was higher among E4 carriers (SUVR = 1.52) than non-carriers (SUVR = 1.31). While mean SUVRs did not differ between Hispanic and non-Hispanic participants;, a statistically significant interaction term indicated that the effect of E4 carrier status on amyloid load was greater among non-Hispanics than Hispanics. Visual assessment, as the gold standard for A+, facilitates determination of the effects of various factors on quantitative thresholds for amyloid positivity. A continuous relationship was found between amyloid load and global cognitive scores, suggesting that any calculated threshold for the whole group, or a subgroup, is artefactual and that the lowest calculated threshold may be optimal for the purposes of early diagnosis and intervention.

[Topic usage of bismuth subgallate as a hemostatic in tonsillectomy]. / Uso tópico del subgalato de bismuto como hemostático en la amigdalectomía.

The most feared complication for the ENT specialists in the adenotonsillectomy is the immediate or mediate haemorrhage after surgery. We revise the literature and contrast experiencies with other colleage. We have found an astringent substance (bismuth subgallate), which helps us give an exact intraoperative diagnosis of the bleeding spot by the colour contrast it shows, and serves us also as a hemostatic, since it activates the XII factor in coagulation. We revise this product regarding its origen, prentation, applications and toxic effects.

Uso tópico del subgalato de bismuto como hemostático en al amigdalectomía / Topic usage of bismuth subgallate as a hemostatic in tonsillectomy

La complicación más temida por los otorrinos en la adenoamigdalectomía es la hemorragia inmediata o mediata a la cirugía. Revisamos la literatura y contrastando experiencias con compañeros de la especialidad, hemos encontrado una sustancia astringente (subgalato de bismuto) que a la vez que nos ayuda al diagnóstico intraoperatorio exacto del punto sangrante por el contraste de color que produce, nos sirve como hemostático ya que activa el factor XII de la coagulación. Hacemos una revisión de este producto en cuanto a su origen, forma de presentación, aplicaciones y efectos tóxicos

The most feared complication for the ENT specialists in the adenotonsillectomy is the immediate or mediate haemorrhage after surgery. We revise the literature and contrast experiencies with other colleage. We have found an astringent substance (bismuth subgallate), which helps us give an exact intraoperative diagnosis of the bleeding spot by the colour contrast it shows, and serves us algo as a hemostatic, since it activates the XII factor in coagulation. We revise this product regarding its origen, prentation, applications and toxic effects

[Sudden hearing loss. Clinical case]. / Hipoacusia súbita. Caso clínico.

In spite of the advance in the diagnose and treatment of sudden hearing loss and specially in the autoimmune sensorineural hearing loss, it is on the field of investigation to fix a specific mark for the latter allness. We refer the diagnostic and therapeutic use of sudden hearing loss and the autoimmune sensorial hearing loss.