Is age-related failure of metabolic reprogramming a principal mediator in idiopathic Parkinson's disease? Implications for treatment and inverse cancer risk.

Idiopathic Parkinson's disease (IPD) is a neurodegenerative disorder characterized by selective degeneration of the substantia nigra pars compacta (SNc), dorsal motor nucleus of the vagus and other vulnerable nervous system regions characterized by extensive axonal arborization and intense energy requirements. Systemic age-related depression of mitochondrial function, oxidative phosphorylation (OXPHOS) and depressed expression of genes supporting energy homeostasis is more severe in IPD than normal aging such that energy supply may exceed regional demand. In IPD, the overall risk of malignancy is reduced.

The Geriatrics in Primary Care Demonstration: Integrating Comprehensive Geriatric Care into the Medical Home: Preliminary Data.

Three thousand nine hundred thirty-one veterans aged 75 and older receive primary care (PC) in two large practices of the Department of Veterans Affairs (VA) Boston Healthcare System. Cognitive and functional disabilities are endemic in this group, creating needs that predictably exceed available or appropriate resources. To address this problem, Geriatrics in Primary Care (GPC) embeds geriatric services directly into primary care.

Does metabolic failure at the synapse cause Alzheimer's disease?

Alzheimer's disease (AD) a neurodegenerative disorder of widely distributed cortical networks evolves over years while A beta (Aβ) oligomer neurotoxicity occurs within seconds to minutes. This disparity combined with disappointing outcomes of anti-amyloid clinical trials challenges the centrality of Aβ as principal mediator of neurodegeneration. Reconsideration of late life AD as the end-product of intermittent regional failure of the neuronal support system to meet the needs of vulnerable brain areas offers an alternative point of view.

Sudden appearance and spontaneous regression of diffuse large B cell lymphoma in a man with a broken arm.

An elderly, demented man with stable κ bi-clonal gammopathy of unknown significance suffered a severe displaced right humeral fracture in a fall. One week later a rapidly enlarging head, neck and axillary adenopathy first appeared, including a 2 cm tonsillar node that partially obstructed the oropharynx. A left cervical node biopsy demonstrated diffuse large B cell lymphoma with CD20+, bcl-2+, κ+, CD3-, Epstein-Barr virus negative malignant cells.

George L. Engel 1913-1999: remembering his life and work: strengthening a father-son bond in a new time of grief.

Objective: This essay reviews George Engel's clinical and scientific contributions within the context of a personal and professional biography. An examination of the response to the abrupt loss of human bonds resulting from the attack on the World Trade Center is used to verify Dr Engel's belief that relationship and communication are central to scientific study in the clinical setting and in the practice of medicine.

Methods: Engel's published autobiographical reports, personal reminiscences, and key scientific publications are reviewed in the light of published or broadcast personal responses to the World Trade Center disaster.