Concurrent Transcatheter Aortic Valve Replacement and Leadless Pacemaker Implantation in a Patient With Aortic Stenosis and Tachycardia-Bradycardia Syndrome.

We present a patient with symptomatic severe aortic stenosis and atrial fibrillation complicated by tachycardia-bradycardia syndrome, deemed too high-risk for surgical valve replacement and referred for transcatheter aortic valve replacement. We show that concurrent implantation of a leadless pacemaker system can be performed successfully with minimal additional risk to the patient, and also, that it can be used to rapidly pace the ventricles to assist in balloon valvuloplasty and prosthetic aortic valve deployment.

Bayer-activities of daily living scale in mild and moderate dementia of the Alzheimer type.

The main purpose of this study is to examine the reliability of the Bayer-Activities of Daily Living (B-ADL) scale when used as a cognitive screening instrument for mild and moderate dementia of the Alzheimer type. This is a retrospective study of 66 patients with dementia. The B-ADL scale was completed by the caregiver or the family member at the first encounter.

Akinetic mutism following stroke.

This is an appraisal of the varied clinical presentation and the neural substrate for akinetic mutism following stroke. The diagnosis is important as akinetic mutism is often misdiagnosed as depression, delirium and locked-in-syndrome. This is a descriptive study of eight selected patients with akinetic mutism following infarction/haemorrhage in different regions of the brain with characteristic syndromes.

Slowly progressive aphasia with striatal involvement.

We have described four patients with slowly progressive aphasia with striatal involvement occurring at different stages in the course of the illness. There were two males and two females, and their ages ranged from 68 to 76 (mean: 72) years. The extrapyramidal signs included tremors, bradykinesia, rigidity, and focal dystonia, and one had weakness resembling stroke.