Gliomatosis cerebri presenting as rapidly progressive dementia and parkinsonism in an elderly woman: a case report

<p>Abstract</p> <p>Introduction</p> <p>Dementia is one of the most important neurological disorders in the elderly. Dementia of tumoral origin is rare and parkinsonism of neoplastic origin is unusual. We herein report a case of gliomatosis cerebri, a very rare brain tumor seldom affecting the elderly, which presented as rapidly progressive dementia and parkinsonism.</p> <p>Case presentation</p> <p>An 82-year-old woman very rapidly developed progressive dementia and akineto-rigid parkinsonism. Brain CT scan was normal. Cerebral magnetic resonance imaging (MRI) with gadolinium injection highlighted a diffuse tumor-related infiltration involving both lobes, the putamen, the pallidum, the substantia nigra, and the brainstem, corresponding to the specific description and definition of gliomatosis cerebri.</p> <p>Conclusion</p> <p>This atypical presentation of a gliomatosis cerebri, and the infiltration of the substantia nigra by the tumor, merits attention.</p

Long-Term Outcomes of the Benefit-Finding Group Intervention for Alzheimer Family Caregivers: A Cluster-Randomized Double-Blind Controlled Trial

Objectives To examine the effects of the group benefit-finding intervention (BFT) for Alzheimer family caregivers up to 10-month follow-up. Design Cluster-randomized double-blind controlled trial. Setting Social centers and clinics. Participants 129 caregivers. Inclusion criteria were (a) primary caregiver aged 18+ and without cognitive impairment, (b) providing ≥14 care hours per week to a relative with mild-to-moderate Alzheimer's disease, and (c) scoring ≥3 on the Hamilton Depression Rating Scale. Exclusion criterion was care-recipient having parkinsonism or other forms of dementia. Interventions BFT (using cognitive reappraisal to find positive meanings) was evaluated against two forms of psychoeducation as controls—standard (STD-PE) and simplified (lectures only; SIM-PE) psychoeducation. All interventions had eight weekly sessions of 2 hours each. Measurements Primary outcome was depressive symptom, whereas secondary outcomes were global burden, role overload, and psychological well-being. Measures were collected at baseline, post-intervention, and 4- and 10-month follow-up. Results Mixed-effects regression showed that BFT's effect on depressive symptoms conformed to a curvilinear pattern, in which the strong initial effect leveled out after post-intervention and was maintained up to 10-month follow-up; this was true when compared against either control group. The effect on global burden was less impressive but moderate effect sizes were found at the two follow-ups. For psychological well-being, there was an increase in the BFT group at 4-month follow-up and a return to baseline afterwards. No effect on role overload was found. Conclusions Benefit-finding reduces depressive symptoms as well as global burden in the long-term, and increases psychological well-being in the medium-term

Diagnosing dementia: No easy job

<p>Abstract</p> <p>Background</p> <p>From both clinical experience and research we learned that in complex progressive disorders such as dementia, diagnosis includes multiple steps, each with their own clinical and research characteristics.</p> <p>Discussion</p> <p>Diagnosing starts with a trigger phase in which the GP gradually realizes that dementia may be emerging. This is followed by a disease-oriented diagnosis and subsequently a care -oriented diagnosis. In parallel the GP should consider the consequences of this process for the caregiver and the interaction between both. As soon as a comprehensive diagnosis and care plan are available, monitoring follows.</p> <p>Summary</p> <p>We propose to split the diagnostic process into four diagnostic steps, followed by a monitoring phase. We recommend to include these steps when designing studies on screening, diagnosis and monitoring of patients with dementia and their families.</p

Challenges and opportunities for conducting a vaccine trial during the COVID-19 pandemic in the United Kingdom

The COVID-19 pandemic has resulted in unprecedented challenges for healthcare systems worldwide. It has also stimulated research in a wide range of areas including rapid diagnostics, novel therapeutics, use of technology to track patients and vaccine development. Here, we describe our experience of rapidly setting up and delivering a novel COVID-19 vaccine trial, using clinical and research staff and facilities in three National Health Service Trusts in Cambridgeshire, United Kingdom. We encountered and overcame a number of challenges including differences in organisational structures, research facilities available, staff experience and skills, information technology and communications infrastructure, and research training and assessment procedures. We overcame these by setting up a project team that included key members from all three organisations that met at least daily by teleconference. This group together worked to identify the best practices and procedures and to harmonise and cascade these to the wider trial team. This enabled us to set up the trial within 25 days and to recruit and vaccinate the participants within a further 23 days. The lessons learned from our experiences could be used to inform the conduct of clinical trials during a future infectious disease pandemic or public health emergency

Review of thermal imaging systems in composite defect detection

Thermal imaging technologies are widely used at present in many industrial areas, while being nowadays more and more employed in R&D&i activities. This article focuses on the comparison of the results obtained with commercially available non-experimental infrared (IR) cameras in the field of non-destructive defect detection. One of the cameras belongs to the FLIR SC5000 series, which is a medium wavelength infrared (MWIR) camera, and the other two cameras are from the high-end ImageIR series manufactured by InfraTec GmbH: The ImageIR 8300 also belongs to the class of MWIR cameras and the ImageIR 8800 is a long wavelength infrared (LWIR) camera. The comparative study is carried out by means of inspecting three different calibrated and induced defect samples with these three cameras using similar excitation sources, so that the configuration and lay out of the tests are comparable with each other. Additionally, after every inspection, a mathematical post-processing is applied to the resulting raw thermal images in order to enhance the detection of defects present in the samples.FANTO

Multisite organization architecture and management for secure and QoS-aware communications between nomad users

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