Open label pilot of personalized, neuroimaging-guided theta burst stimulation in early-stage Alzheimer's disease.

Background: Alzheimer's disease (AD) is characterized by cerebral amyloid plaques and neurofibrillary tangles and disruption of large-scale brain networks (LSBNs). Transcranial magnetic stimulation (TMS) has emerged as a potential non-invasive AD treatment that may serve as an adjunct therapy with FDA approved medications.

Methods: We conducted a 10-subject open label, single site study evaluating the effect of functional connectivity-resting state functional MRI guided-approach to TMS targeting with dysfunctional LSBNs in subjects with biomarker-confirmed early-stage AD (https://clinicaltrials.

Intracerebral hemorrhage following mild ARIA-H in an APOE ε2 carrier receiving lecanemab.

Objective: Report a case of an apolipoprotein E (APOE)ε2 carrier receiving lecanemab who developed late onset intracerebral hemorrhage (ICH) following amyloid-related imaging abnormalities-hemorrhage (ARIA-H).

Method: We detail the history and neuroimaging findings of a 73-year-old male with Alzheimer's disease (APOEε2/ε3 status) who developed ICH after mild ARIA-H and suffering a fall.

Results: The patient developed mild ARIA-H after his 13th infusion that was proceeded by left temporo-occipital hemorrhage following his 14th infusion.

An Atypical Presentation of Gonococcal Endocarditis.

A 53-year-old male presented following cardiac arrest, followed by cardiopulmonary resuscitation. He was found to have myocardial infarction, bihemispheric cerebral embolization and mitral valve endocarditis. Mitral valve replacement was performed and was detected on PCR.

Left dural carotid cavernous fistula mimicking an inflammatory process: A case report.

A female in her 70s presented with altered mental status, left eye pain, ophthalmalgia, and diplopia following a fall. Brain MRI demonstrated contrast-enhancing left peri-insular T2 hyperintense changes that was read as possible herpes simplex encephalitis by neuroradiology. Cerebral angiogram revealed a Barrow Type D left sided carotid cavernous fistula.

Abnormal clinical presentation and surgical outcome of an intraventricular cavernoma of the third ventricle.

We present a unique case of a man presenting with progressive short-term memory deficits over 10+ years who was found to have a large intraventricular cavernoma in the anterior wall of the third ventricle with invasion of medial limbic structures. Identifying intraventricular cavernomas early is crucial to prevent substantial growth and to increase the chance of successful patient outcomes.

Implementation and review of the care ecosystem in an integrated healthcare system.

Background And Objectives: The University of California, San Francisco Memory and Aging Center (UCSF-MAC) led the development and tested a collaborative care model delivered by lay care team navigators (CTNs) with support from a multidisciplinary team known as the Care Ecosystem (CE). We evaluated outcomes related to the feasibility of the CE in a non-academic healthcare system, including acceptability, adoption, and fidelity to the original UCSF model.

Research Design And Methods: The CE team at HealthPartners consisted of two CTNs, a social worker, an RN, a program coordinator, and a behavioral neurologist.

A Case of Minimally Progressive Prodromal Alzheimer's Disease.

Prodromal Alzheimer's disease (AD) is a neurodegenerative condition typically progressing to dementia within 3 years. We describe a case of a mild cognitive impairment (MCI) patient with biomarker evidence for amyloidosis, tau, and neurodegeneration who had minimal changes in clinical phenotype during an 11-year period. AD biomarkers were obtained with cerebrospinal fluid analysis and amyloid PET imaging, both of which supported a biological diagnosis of AD.

Eight-year outcomes of aortic valve replacement with the Carpentier-Edwards PERIMOUNT Magna Ease valve.

Introduction: The Carpentier-Edwards PERIMOUNT Magna Ease valve is a third-generation bioprosthesis for aortic valve replacement (AVR). This is a postapproval study reporting on its 8-year outcomes.

Methods: Adults undergoing AVR with the Magna Ease valve between October 2007 and December 2012 were enrolled for this prospective, nonrandomized, single-arm, and multicenter study.

Brain Glucose Hypometabolism and Iron Accumulation in Different Brain Regions in Alzheimer's and Parkinson's Diseases.

The aim of this study was to examine the relationship between the presence of glucose hypometabolism (GHM) and brain iron accumulation (BIA), two potential pathological mechanisms in neurodegenerative disease, in different regions of the brain in people with late-onset Alzheimer's disease (AD) or Parkinson's disease (PD). Studies that conducted fluorodeoxyglucose positron emission tomography (FDG-PET) to map GHM or quantitative susceptibility mapping-magnetic resonance imaging (QSM-MRI) to map BIA in the brains of patients with AD or PD were reviewed. Regions of the brain where GHM or BIA were reported in each disease were compared.

Responding to the Needs of Persons Living With Dementia and Their Caregivers During the COVID-19 Pandemic: Lessons From the Care Ecosystem.

Background And Objectives: The coronavirus disease 2019 (COVID-19) pandemic created challenges for persons with dementia, their caregivers, and programs that support them. The Care Ecosystem (CE) is a model of dementia care designed to support people with dementia and their family caregiver dyads through ongoing contact with a care team navigator (CTN) and an expert clinical team. CTNs provide support, education, and resources and help dyads manage dementia-related concerns as they evolve over the course of the disease.

Rapid Development and Deployment of an Intensivist-Led Venovenous Extracorporeal Membrane Oxygenation Cannulation Program.

Objectives: To determine the safety and efficacy of a rapidly deployed intensivist-led venovenous extracorporeal membrane oxygenation cannulation program in a preexisting extracorporeal membrane oxygenation program.

Design: A retrospective observational before-and-after study of 40 patients undergoing percutaneous cannulation for venovenous extracorporeal membrane oxygenation in an established cannulation program by cardiothoracic surgeons versus a rapidly deployed medical intensivist cannulation program.

Setting: An adult ICU in a tertiary academic medical center in Camden, NJ.

Inferior Vena Cava Obstruction Following Surgical Repair of a Secundum Atrial Septal Defect.

Obstruction of the inferior vena cava (IVC) following surgical repair of an atrial septal defect (ASD) is a rare complication. We present the case of a patient who developed IVC obstruction following surgical repair of a large secundum ASD. The diagnostic and management approaches used to care for this patient are discussed.

The books are alive with biological data: an introduction to the field of biocodicology and its implications for historical health sciences collections.

Recent global events have underscored the need for broad access to digitized library special collections. At the same time, a burgeoning field of scientific and historical inquiry is finding a goldmine of data in the physical old books and manuscripts stored for centuries on library shelves. This article gives an overview of some of the interesting studies employing library materials in the new field of biocodicology, which expands the field of codicology (learning about book history through studying a copy's physical attributes, sometimes referred to as "archaeology of the book") to interrogate physical books with proteomic, genomic, and microbiomic tools.

Prodromal Dementia With Lewy Bodies: Evolution of Symptoms and Predictors of Dementia Onset.

Background: Research criteria for prodromal dementia with Lewy bodies (DLB) were published in 2020, but little is known regarding prodromal DLB in clinical settings.

Methods: We identified non-demented participants without neurodegenerative disease from the National Alzheimer's Coordinating Center Uniform Data Set who converted to DLB at a subsequent visit. Prevalence of neuropsychiatric and motor symptoms were examined up to 5 years prior to DLB diagnosis.

A Phase II, Single-Center, Randomized, Double-Blind, Placebo-Controlled Study of the Safety and Therapeutic Efficacy of Intranasal Glulisine in Amnestic Mild Cognitive Impairment and Probable Mild Alzheimer's Disease.

Background: Intranasal insulin is a potential treatment for neurodegenerative disease shown to increase cerebral glucose uptake, reduce amyloid plaques, and improve verbal memory in cognitively impaired as well as healthy adults. Investigations have suggested rapid-acting insulins such as glulisine may result in superior cognitive benefits compared with regular insulin.

Objective: The aim of this study was to evaluate the safety and efficacy of rapid-acting intranasal glulisine in subjects with amnestic mild cognitive impairment (MCI) or mild probable Alzheimer's disease (AD).

A Pilot Study Comparing Aortic Valve Area Estimates Derived from Fick Cardiac Output with Estimates Based on Cheetah-NICOM Cardiac Output.

Cardiac output during cardiac catheterization is often estimated using the modified Fick method (CO). In this proof-of-concept, prospective non-randomized study carried out in a single academic healthcare centre, we examined whether replacing CO in the Gorlin formula with Cheetah-NICOM monitor cardiac output (CO) could produce an accurate and precise estimate of aortic valve area in patients with severe aortic stenosis. In twenty-six subjects, CO and CO were obtained concurrently.

Double-Blind Placebo-Controlled Pilot Investigation of the Safety of a Single Dose of Rapid-Acting Intranasal Insulin in Down Syndrome.

Background: Individuals with Down syndrome are likely to develop clinical and neuropathological brain changes resembling Alzheimer's disease dementia by the ages of 35-40 years. Intranasal insulin is a potential treatment for neurodegenerative disease that has been shown to reduce amyloid plaque burden and improve verbal memory performance in normal as well as memory-impaired adults. Investigations have shown that rapid-acting insulins may result in superior cognitive benefits compared with regular insulin.

Asanguinous Del Nido Cardioplegia for an Aortic Valve Replacement Patient with Cold Agglutinins.

A patient with known cold agglutinins requiring an aortic valve replacement was referred for surgery. Asanguinous, Del Nido cardioplegia was used for myocardial protection. Warm induction followed by cold infusion prevented any agglutination and eliminated the need for subsequent cardioplegia doses.

Screening Positive for Cognitive Impairment: Impact on Healthcare Utilization and Provider Action in Primary and Specialty Care Practices.

Background: Alzheimer's disease, the most common cause of dementia, goes unrecognized in half of patients presenting to healthcare providers and is associated with increased acute care utilization. Routine cognitive screening of older adults in healthcare settings could improve rates of dementia diagnosis and patterns of healthcare utilization.

Objective: To evaluate the impact of screening positive for cognitive impairment on provider action in primary and specialty care practices and patient healthcare utilization.

Unexpected Left Atrial Thrombus After Aortic Valve Replacement and Left Atrial Ligation With AtriClip Device: A Case Report.

We report the unexpected transesophageal echocardiography (TEE) finding of a left atrial (LA) thrombus near the end of cardiopulmonary bypass and after deployment of an AtriClip (Atricure, Inc, Westchester, OH) in an 84-year-old man with atrial fibrillation and aortic stenosis undergoing aortic valve replacement and LA appendage ligation. TEE examination before cardiopulmonary bypass and deployment of the AtriClip had not shown a thrombus in the LA appendage. The heart was rearrested and thrombus was successfully removed through a left atriotomy.

Susac syndrome with prominent dermatological findings and a prompt response to intravenous immunoglobulin, steroids, and rituximab: a case report.

Background: Susac syndrome (retinocochleocerebral vasculopathy) is an autoimmune endotheliopathy affecting the precapillary arterioles of the brain, retina, and inner ear. It presents with encephalopathy, branch retinal artery occlusions, and hearing loss. The condition is often under recognized because the clinical symptoms may present at different times and physicians may be unfamiliar with the syndrome.

Routine cognitive screening in a neurology practice: Effect on physician behavior.

Background: Alzheimer disease is one of the most prevalent and costly neurologic disorders. American Academy of Neurology guidelines call for diagnosis and treatment when dementia is present, but provide no specific instruction relating to cognitive screening.

Methods: Our center piloted a cognitive screening initiative using the Mini-Cog, which was administered to all neurology patients aged ≥70 years without a history of a cognitive disorder.

White matter microstructural recovery with abstinence and decline with relapse in alcohol dependence interacts with normal ageing: a controlled longitudinal DTI study.

Background: Alcohol dependence exacts a toll on brain white matter microstructure, which has the potential of repair with prolonged sobriety. Diffusion tensor imaging (DTI) enables in-vivo quantification of tissue constituents and localisation of tracts potentially affected in alcohol dependence and its recovery. We did an extended longitudinal study of alcoholism's trajectory of effect on selective fibre bundles with sustained sobriety or decline with relapse.