Blarcamesine for the treatment of Early Alzheimer's Disease: Results from the ANAVEX2-73-AD-004 Phase IIB/III trial.

Background: There are no approved oral disease-modifying treatments for Alzheimer's disease (AD).

Objectives: The objective of this study was to assess efficacy and safety of blarcamesine (ANAVEX®2-73), an orally available small-molecule activator of the sigma-1 receptor (SIGMAR1) in early AD through restoration of cellular homeostasis including autophagy enhancement.

Design: ANAVEX2-73-AD-004 was a randomized, double-blind, placebo-controlled, 48-week Phase IIb/III trial.

Assessing the metabolism of the olfactory circuit by use of F-FDG PET-CT imaging in patients suspected of suffering from Alzheimer's disease or frontotemporal dementia.

Purpose: The loss of olfactory function is known to occur in patients suffering from (behavioral variant) frontotemporal dementia ((bv)FTD) and Alzheimer's disease (AD), although different pathophysiological mechanisms underpin this clinical symptom in both disorders. This study assessed whether brain metabolism of the olfactory circuit as assessed by positron emission tomography (PET) imaging with 2-[fluorine-18]fluoro-2-deoxy-d-glucose ([F]-FDG) can distinguish these entities in different subsets of patients.

Methods: Patients presenting with cognitive decline were included from a prospectively kept database: (1) bvFTD patients, (2) AD patients and (3) patients with logopenic primary progressive aphasia (PPA).

Complications and Long-Term Outcome in 30 Canine Total Hip Arthroplasties Using a Second-Generation Selective Laser Melted Screw Cup.

Objective:  The aim of this study was to report complications and outcomes of a cementless total hip arthroplasty (THA) system with a second-generation selective laser-melted screw cup (SCSL).

Study Design:  All THA using the SCSL performed at a single institution between January 2017 and November 2022 were retrospectively evaluated. Patients with a minimum follow-up period of 12 months and complete medical records were included and analyzed for radiographic and clinical outcomes.

Performing a Three-Dimensional Finite Element Analysis to Simulate and Quantify the Contact Pressure in the Canine Elbow Joint: A Pilot Study.

Objective:  The aim of this study was to measure surface pressures and force distribution on radius and ulna in healthy and dysplastic elbow joints in different positions using the finite element analysis (FEA).

Study Design:  FEA was performed on computed tomographic data of healthy and fragmented coronoid process diseased elbow joints of Labrador Retrievers. It considered the articular cartilage, collateral ligaments, triceps and biceps muscle.

The effect of steam sterilization on different 3D printable materials for surgical use in veterinary medicine.

Background: Different 3D-printed materials polyactic acid (PLA), polyamide (PA), polycarbonates (PC), acrylonitrile butadiene styrene (ABS) and GreenTEC Pro® have been considered for surgical templates, but there is a sparity of data about how these materials are affected by steam sterilization. The aim of the current study was to test if and how these materials change morphologically when high temperature, pressure and humidity are applied during the steam sterilization process. The overall aim is to create patient-specific sawing templates for performing corrective osteotomies.

[Rivastigmine as treatment for flashbacks and REM sleep problems in an older patient].

A 61-year-old woman with suspected schizophrenia has been attending an outpatient geriatrics service for some time, initially with memory complaints and panic attacks. During treatment, the diagnosis schizophrenia was rejected and psychopharmaceuticals were largely phased out, which improved cognitive functions. Eventually, flashbacks of incest experienced in childhood remained together with REM sleep pathology.

Validity of the Mini-Mental State Examination-2 in Diagnosing Mild Cognitive Impairment and Dementia in Patients Visiting an Outpatient Clinic in the Netherlands.

This study examined the utility of the recently published MMSE-2:SV in detecting cognitive impairment. We used receiver operating characteristics to test the discriminative power of the MMSE-2:SV for distinguishing between older adults without mild cognitive impairment (MCI) or dementia (n=67) and patients with MCI (n=76) or dementia (n=79). The results show that the MMSE-2:SV had excellent discriminative ability in distinguishing older controls from patients with dementia, with cut-off scores of 26 and 27 (max=30) yielding appropriate sensitivity (0.

Implementation of point-of-care testing and a temporary influenza ward in a Dutch hospital.

Background: The seasonal influenza epidemic poses a significant burden on hospitals, both in terms of capacity and costs. Beds that are occupied by isolated influenza patients result in hospitals temporary being closed to admissions and elective operations being cancelled. Improving hospital and emergency department (ED) patient flow during the influenza season could solve these problems.

[Not every delirium protocol in Dutch hospitals is up-to-date: evaluation of the implementation of the new delirium guideline].

Objective: To describe the extent to which the essential changes in the new Dutch delirium guideline for adults and the elderly, published in April 2014, have been incorporated in local hospital protocols, so as to estimate the consequences this could have for patients.

Design: Quantitative study.

Method: Dutch hospital protocols were collected for two periods: before (September to December 2012) and after publication of the guideline (March to July 2015).

Prefrontal activation may predict working-memory training gain in normal aging and mild cognitive impairment.

Cognitive training has been shown to result in improved behavioral performance in normal aging and mild cognitive impairment (MCI), yet little is known about the neural correlates of cognitive plasticity, or about individual differences in responsiveness to cognitive training. In this study, 21 healthy older adults and 14 patients with MCI received five weeks of adaptive computerized working-memory (WM) training. Before and after training, functional Near-Infrared Spectroscopy (fNIRS) was used to assess the hemodynamic response in left and right prefrontal cortex during performance of a verbal n-back task with varying levels of WM load.

Transfer and maintenance effects of online working-memory training in normal ageing and mild cognitive impairment.

Working memory (WM) is one of the cognitive functions that is susceptible to ageing-related decline. Interventions that are able to improve WM functioning at older age are thus highly relevant. In this pilot study, we explored the transfer effects of core WM training on the WM domain and other cognitive domains in 23 healthy older adults and 18 patients with amnestic mild cognitive impairment (MCI).

[Revised practice guidelines 'Delirium in adults and the elderly'].

A multidisciplinary workgroup has revised the 2004 practice guidelines on 'Delirium' on the initiative of the Dutch Geriatrics Society. In comparison with the previous version, the new guidelines place more emphasis on screening and non-pharmaceutical prevention and treatment. They recommend a degree of restraint when prescribing medication.

[Practice guideline 'Delirium' from the Dutch College of General Practitioners].

The revised practice guideline 'Delirium' of the Dutch College of General Practitioners (NHG) provides recommendations about the prevention, early detection, diagnosis and treatment of delirium in elderly patients in general practice. The guideline now also offers tools for the treatment of delirium in terminally-ill patients. A patient with delirium can only be cared for at home if a safe environment and the continuous presence of carers can be guaranteed.

Differences in nutritional status between very mild Alzheimer's disease patients and healthy controls.

Background: Studies on the systemic availability of nutrients and nutritional status in Alzheimer's disease (AD) are widely available, but the majority included patients in a moderate stage of AD.

Objective: This study compares the nutritional status between mild AD outpatients and healthy controls.

Methods: A subgroup of Dutch drug-naïve patients with mild AD (Mini-Mental State Examination (MMSE) ≥20) from the Souvenir II randomized controlled study (NTR1975) and a group of Dutch healthy controls were included.

[Discussing the resuscitation policy at a geriatric ward: the experience of patients or their representatives].

Aim: To identify geriatric patients' and their surrogate decision makers' experience with regard to discussing cardio pulmonary resuscitation (CPR) policy.

Methods: This is a prospective, observational, explorative survey. During 10 weeks, all patients admitted to a geriatric ward of a general Dutch hospital or their representatives were asked for their experience regarding discussion of the resuscitation policy with the physician in attendance.

[Applicability and validity of the Dutch version of the Montreal Cognitive Assessment (moCA-d) in diagnosing MCI].

Objective: The MoCA is a new screening test to detect Mild Cognitive Impairment (MCI). Purpose of this study is validating the Dutch version (MoCA-D).

Method: We administered the MoCA-D to healthy control subjects and to elderly with MCI or dementia from a memory disorder outpatient clinic and a geriatric (outpatient) clinic (n = 30, 32, 37 respectively, age > or = 60).

Delirium after emergency/elective open and endovascular aortoiliac surgery at a surgical ward with a high-standard delirium care protocol.

Delirium is a common problem in elderly patients undergoing surgery. Standard delirium care is not available at all surgical wards. We determined the incidence, risk factors, and outcomes of postoperative delirium among patients undergoing elective/emergency aortoiliac surgery at a surgical ward with high-standard delirium care.

Outcome of colonic surgery in elderly patients with colon cancer.

Introduction. Colonic cancer is one of the most commonly diagnosed malignancies and most often occurs in patients aged 65 years or older. Aim.

[Oral galantamine versus rivastigmine transdermal patch: a descriptive study at a memory clinic in The Netherlands].

Objectives: Since January 2008 in The Netherlands, two cholinesterase inhibitors, oral galantamine and rivastigmine transdermal patch, are registered as a one-day symptomatic treatment for Alzheimer's disease. As no head to head study was performed yet, the objective of this study was to describe the daily practice of oral galantamine and rivastigmine transdermal patch in a real life population of a memory clinic of a suburban teaching hospital in The Netherlands.

Methods: A randomized open label study in 84 ambulant Alzheimer's patients with at least 6 months follow-up and treated either with oral galantamine (group G) or rivastigmine transdermal patch (group R).

[The possible value of diagnosing MCI-DLB and treatment options].

Dementia with Lewy Bodies (DLB) is a well-described clinical entity. DLB patients can be treated with acetylcholinesterase inhibitors (AChEI's). However, should we also treat patients who have but part of the symptoms and who are currently described as MCI-DLB? Will these MCI-DLB patients benefit from AChEI's in terms of direct effect on cognition and behaviour and final outcome? Two cases are presented to demonstrate the clinical features of MCI-DLB and the effect of treatment with rivastigmine (AChEI).