OBJECTIVE: The main objective is to confirm a hypothesis that atherosclerosis, through various mechanisms, considerably influences cognitive impairment and significantly increases the risk for developing dementia. Complete sample should be 920 individuals. The present study aimed to analyse epidemiological data from a questionnaire survey. METHODS: The work was carried out in the form of an epidemiological case control study. Subjects are enrolled in the study based on results of the following examinations carried out in neurology departments and outpatient centres during the project NU20-09-00119 from 2020 to 2023. Respondents were divided into four research groups according to the results of clinical examination for the presence of atherosclerosis and dementia. The survey was mainly concerned with risk factors for both atherosclerosis and dementia. It contained questions on lifestyle factors, cardiovascular risk factors, leisure activities, and hobbies. RESULTS: Analysis of the as yet incomplete sample of 877 subjects has yielded the following selected results: on average, 16% of subjects without dementia had primary education while the proportion was 45.2% in the group with both dementia and atherosclerosis. Subjects with dementia did mainly physical work. Low physical activity was more frequently noted in dementia groups (Group 2 - 54.4% and Group 3 - 47.2%) than in subjects without dementia (Group 1 - 19.6% and Group 4 - 25.8%). Coronary heart disease was more frequently reported by dementia patients (33.95%) than those without dementia (16.05%). CONCLUSION: Cognitively impaired individuals, in particular those with vascular cognitive impairment, have poorer quality of life and shorter survival. Risk factors contributing to such impairment are similar to those for ischaemic or haemorrhagic stroke. It may be concluded that most of the analysed risk factors play a role in the development of both atherosclerosis and dementia.
- MeSH
- ateroskleróza * epidemiologie MeSH
- demence * epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- životní styl MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Serum neurofilament light chain (S NfL) is a non-specific marker of neuronal damage, including Alzheimer's disease (AD). We aimed to verify the reference interval (RI) of serum NfL using a highly sensitive ELISA, and to estimate the optimal cut-off value for neuronal damage. Our second objective was to compare NfL in cerebrospinal fluid (CSF) and serum (S) with the routine neurodegeneration biomarkers used in AD, and to assess their concentrations relative to the degree of cognitive deficit. METHODS: Samples from 124 healthy volunteers were used to estimate the S NfL RI. For the comparison study, we used CSF and S samples from 112 patients with cognitive disorders. Cognitive functions were assessed using the mini-mental state examination. ELISA assays were used to determine the CSF and S NfL levels, CSF β-amyloid peptide42 (Aβ42), CSF β-amyloid peptide40 (Aβ40), CSF total tau protein (tTau), CSF phosphorylated tau protein (pTau), and CSF alpha-synuclein (αS). RESULTS: The estimated RI of S NfL were 2.25-9.19 ng.L-1. The cut-off value of S NfL for assessing the degree of neuronal impairment was 10.5 ng.L-1. We found a moderate statistically significant correlation between S NfL and CSF Aβ42 in the group with movement disorders, without dementia (rs = 0.631; p = 0.016); between S NfL and CSF Aβ40 in the group with movement disorder plus dementia (rs = -0.750; p = 0.052); between S NfL and CSF tTau in the control group (rs = 0.689; p = 0.009); and between S NfL and CSF pTau in the control group (rs = 0.749; p = 0.003). The non-parametric Kruskal-Wallis test revealed statistically significant differences between S NfL, CSF NfL, CSF Aβ42, CSF tTau, and CSF pTau and diagnosis within groups. The highest kappa coefficients were found between the concentrations of S NfL and CSF NfL (κ = 0.480) and between CSF NfL and CSF tTau (κ = 0.351). CONCLUSION: Our results suggested that NfL and tTau in CSF of patients with cognitive decline could be replaced by the less-invasive determination of S NfL using a highly sensitive ELISA method. S NfL reflected the severity of cognitive deficits assessed by mini-mental state examination (MMSE). However, S NfL is not specific to AD and does not appear to be a suitable biomarker for early diagnosis of AD.
- Publikační typ
- časopisecké články MeSH
PURPOSE: Transcranial sonography (TCS) magnetic resonance (MR) fusion imaging and digital image analysis are useful tools for the evaluation of various brain pathologies. This study aimed to compare the echogenicity of predefined brain structures in Huntington's disease (HD) patients and healthy controls by TCS-MR fusion imaging using Virtual Navigator and digitized image analysis. MATERIALS AND METHODS: The echogenicity of the caudate nucleus (CN), substantia nigra (SN), lentiform nucleus (LN), insula, and brainstem raphe (BR) evaluated by TCS-MR fusion imaging using digitized image analysis was compared between 21 HD patients and 23 healthy controls. The cutoff values of echogenicity indices for the CN, LN, insula, and BR with optimal sensitivity and specificity were calculated using receiver operating characteristic analysis. RESULTS: The mean echogenicity indices for the CN (67.0±22.6 vs. 37.9±7.6, p<0.0001), LN (110.7±23.6 vs. 59.7±11.1, p<0.0001), and insula (121.7±39.1 vs. 70.8±23.0, p<0.0001) were significantly higher in HD patients than in healthy controls. In contrast, BR echogenicity (24.8±5.3 vs. 30.1±5.3, p<0.001) was lower in HD patients than in healthy controls. The area under the curve was 90.9%, 95.5%, 84.1%, and 81.8% for the CN, LN, insula, and BR, respectively. The sensitivity and specificity were 86% and 96%, respectively, for the CN and 90% and 100%, respectively, for the LN. CONCLUSION: Increased CN, LN, and insula echogenicity and decreased BR echogenicity are typical findings in HD patients. The high sensitivity and specificity of the CN and LN hyperechogenicity in TCS-MR fusion imaging make them promising diagnostic markers for HD.
- MeSH
- dospělí MeSH
- Huntingtonova nemoc * diagnostické zobrazování MeSH
- interpretace obrazu počítačem metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- mozek * diagnostické zobrazování MeSH
- mozková kůra diagnostické zobrazování MeSH
- multimodální zobrazování metody MeSH
- nucleus caudatus diagnostické zobrazování MeSH
- počítačové zpracování obrazu metody MeSH
- referenční hodnoty MeSH
- ROC křivka MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- ultrasonografie dopplerovská transkraniální metody MeSH
- uživatelské rozhraní počítače MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Bilateral deep brain stimulation (DBS) of the globus pallidus internus (GPi) is an effective treatment for refractory dystonia. Neuroradiological target and stimulation electrode trajectory planning with intraoperative microelectrode recordings (MER) and stimulation are used. With improving neuroradiological techniques, the need for MER is in dispute mainly because of the suspected risk of hemorrhage and the impact on clinical post DBS outcome. OBJECTIVE: The aim of the study is to compare the preplanned GPi electrode trajectories with final trajectories selected for electrode implantation after electrophysiological monitoring and to discuss the factors potentially responsible for differences between preplanned and final trajectories. Finally, the potential association between the final trajectory selected for electrode implantation and clinical outcome will be analyzed. METHODS: Forty patients underwent bilateral GPi DBS (right-sided implants first) for refractory dystonia. The relationship between preplanned and final trajectories (MicroDrive system) was correlated with patient (gender, age, dystonia type and duration) and surgery characteristics (anesthesia type, postoperative pneumocephalus) and clinical outcome measured using CGI (Clinical Global Impression parameter). The correlation between the preplanned and final trajectories together with CGI was compared between patients 1-20 and 21-40 for the learning curve effect. RESULTS: The trajectory selected for definitive electrode implantation matched the preplanned trajectory in 72.5% and 70% on the right and left side respectively; 55% had bilateral definitive electrodes implanted along the preplanned trajectories. Statistical analysis did not confirm any of the studied factors as predictor of the difference between the preplanned and final trajectories. Also no association between CGI and final trajectory selected for electrode implantation in the right/left hemisphere has been proven. The percentages of final electrodes implanted along the preplanned trajectory (the correlation between anatomical planning and intraoperative electrophysiology results) did not differ between patients 1-20 and 21-40. Similarly, there were no statistically significant differences in CGI (clinical outcome) between patients 1-20 and 21-40. CONCLUSION: The final trajectory selected after electrophysiological study differed from the preplanned trajectory in a significant percentage of patients. No predictor of this difference was identified. The anatomo-electrophysiological difference was not predictive of the clinical outcome (as measured using CGI parameter).
- Publikační typ
- časopisecké články MeSH
The severity of plant poisonings is documented by annual reports on deaths caused by mistaking colchicum leaves for wild garlic, and this is not the only problem that can be brought about by unwise use of natural plant products. We present an overview of poisonings caused by confusion with edible plants, while considering the possible presence of neurological symptoms. These conditions are infrequent, but can be encountered during acute neurological evaluations. Since it is necessary to identify and know how to manage them, possible methods of treatment are briefly outlined. Our paper deals with plants of Central European biotopes, which, although infrequent, may even have fatal consequences.
Závažnost intoxikací rostlinami nám dokládají každoroční zprávy o úmrtí způsobeném záměnou listů ocúnu za medvědí česnek, a to není jediný problém, který může přivodit nerozumné požívání přírodních rostlinných produktů. Předkládáme přehled otrav způsobených záměnami za jedlé rostliny s ohledem na možnost přítomnosti neurologických příznaků. Tyto stavy nejsou časté, ale při akutních neurologických vyšetřeních se s nimi můžeme setkat. Je nutné je znát a umět řešit, proto jsme stručně nastínili i možné způsoby léčby. V našem sdělení se zabýváme rostlinami z biotopů našeho podnebného pásma střední Evropy, které, ač nejsou časté, mohou mít i fatální následky.
Úvod: Vzhledem k stárnutí populace a prodlužování střední délky života se v budoucnu očekává nárůst prevalence demence a onemocnění na podkladě aterosklerózy. Obě tyto závažné diagnózy mají řadu společných rizikových faktorů. Navíc ateroskleróza karotid je považována za prediktor demence. Vzájemný vztah ovšem není stále dostatečně objasněn. Hlavním cílem předkládané práce bylo popsat souvislost mezi vybranými rizikovými faktory aterosklerózy a demence. Metodika: K analýze rizikových faktorů byl použit soubor 1337 jedinců z projektu AZV MZ ČR „Možný vliv aterosklerózy na rozvoj demence“, který je koncipován jako epidemiologická studie případů a kontrol. Subjekty studiebyly rozděleny do čtyř výzkumných skupin podle výsledků klinického vyšetření na přítomnost aterosklerózy a demence. Výsledky: Mezi všemi výzkumnými skupinami byly zjištěny statisticky významné rozdíly ve výskytu rizikových faktorů, zejména mezi jedinci s demencí, ale bez aterosklerózy a jedinci s aterosklerózou, ale bez demence. Jedinci s demencí a bez aterosklerózy mají statistický významně častěji základní vzdělání (p < 0,001) a jsou méně často v manželském svazku (p < 0,001). Jedinci s demencí (ať už v kombinaci s aterosklerózou, nebo bez) statisticky významně méně častovykonávali pohybovou aktivitu (p < 0,001) a méně často se věnovali aktivitám, jako je čtení a luštění křížovek (p <0,001). Konkrétně u čtení a jedinců s demencí a aterosklerózou bylo zjištěno statisticky významně vyšší riziko vznikuonemocnění (OR = 1,72; IS 1,02–2,88; p = 0,041) oproti kontrolní skupině. Naopak jedinci s aterosklerózou a bez demence statisticky významně častěji kouří (p < 0,001), mají hypertenzi (p < 0,001), vysoký cholesterol (p < 0,001) a diabetes mellitus (p = 0,018). Závěr: Demence i ateroskleróza jsou velmi závažná onemocnění, podrobná znalost rizikových faktorů u těchto nemocí je nezbytná. Mnohé z těchto rizikových faktorů jsou společné pro obě diagnózy a pochopení vzájemného vztahu mezi nimi může pomoci v prevenci a včasném odhalení demence.
Introduction: Due to the aging of the population and the increase in life expectancy, an increase in the prevalence of dementia and atherosclerosis-based diseases is expected in the future. Both of these severe diagnoses have severalcommon risk factors. In addition, carotid atherosclerosis is considered as a predictor of dementia. However, the mutual relationship is still not sufficiently clarified. The main goal of the presented work was to describe the connectionbetween selected risk factors of atherosclerosis and dementia. Methods: A set of 1,337 individuals from the AZV MZ CR project "Possible influence of atherosclerosis on the development of dementia", designed as an epidemiological study of cases and controls, was used to analyze risk factors. The study subjects were divided into four research groups according to the clinical examination results for the presence of atherosclerosis and dementia. Results: Statistically significant differences in the occurrence of risk factors were found between all research groups, especially between individuals with dementia but without atherosclerosis and individuals with atherosclerosis but without dementia. Individuals with dementia and without atherosclerosis have statistically significantly more often primary education (p < 0.001) and are less often married (p < 0.001). Individualswith dementia (whether combined with atherosclerosis or without) were statistically significantly less likely to engage inphysical activity (p < 0.001) and less often engaged in activities such as reading and crossword (p < 0.001). Specifically, reading and individuals with dementia and atherosclerosis were found to have a statistically significantly higher risk of developing the disease (OR = 1.72; IS 1.02–2.88; p = 0.041) compared to the control group. On the contrary, individuals with atherosclerosis and without dementia are statistically significantly more likely to smoke (p < 0.001), have hypertension (p < 0.001), high cholesterol (p < 0.001), and diabetes mellitus (p = 0.018). Conclusion: Dementia and atherosclerosis are very serious diseases, and detailed knowledge of the risk factors for these diseases is essential. Many of these risk factors are common to both diagnoses and understanding the interrelationship betweenthem can help in the prevention and early detection of dementia.
- MeSH
- ateroskleróza * diagnóza MeSH
- demence * diagnóza prevence a kontrola MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
The objective was to identify the attitudes of progressive neurological disease (PND) patients and their family members regarding end-of-life care, and their worries about dying. The sample included 327 participants. The Attitudes of Patients with PND to End-of-Life Care questionnaire was used to collect the data. Statistically significant differences in the assessment of attitudes towards end-of-life care between patients and family members were identified (p < 0.001). Family members more frequently favored patients being kept alive at any cost; patients more commonly wished to have their end of life under control. Respondents most frequently deferred to doctors when it came to decisions on treatment to keep patients alive. However, both patients and family members wanted patients to be able to decide on their treatment by leaving a written record of their previously stated wishes. The demands of patients and their families regarding end-of-life care should be documented in individual care plans.
- MeSH
- lidé MeSH
- péče o umírající * MeSH
- postoj MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- rodina MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND Histiocytic sarcoma is a rare malignant hematopoietic neoplasm with morphologic and immunohistochemical features of histiocytic differentiation, usually with unfavorable prognosis. Despite aggressive biological behavior, in subgroup of patients with localized disease, the prognosis can be very good. Few publications are available on localized cases of histiocytic sarcoma. These occur infrequently and continue to be a poorly-recognized morphological entity. CASE REPORT A 73-year old man treated for Parkinson syndrome presented with a tumor resistance on the dorsal surface of the left forearm. This lesion was clinically seen as an organized hematoma and was surgically resected. Histologically, the tumor was situated in the dermis and subcutis and it consisted of multiple neoplastic nodules. Vasoformative growth patterns with the vascular-like spaces containing erythrocytes and hemosiderin pigment presence simulated the morphology of angiosarcoma. Based on the immunohistochemical characteristics, we diagnosed the tumor as cutaneous histiocytic sarcoma. Genetic analysis revealed immunoglobulin heavy-chain gene rearrangement without any concomitant hematological malignancy. The patient demonstrated no systemic disease or impairment associated with diagnosed histiocytic sarcoma, and no recurrence has been found to date. CONCLUSIONS We report a case of primary cutaneous histiocytic sarcoma with an excellent outcome after surgical treatment only. Clinical data and histopathological and immunohistochemical evaluation were essential to rule out other malignant tumors in the differential diagnosis. Genetic analysis together with up-to-date knowledge and understanding of principles of tumorous transformations helped to diagnose this poorly-recognized entity with various clinical behaviors.
