Purpose: To evaluate the effect of levodopa on apparent diffusion coefficient (ADC) value of the brain parenchyma in patients with idiopathic Parkinson disease (PD).
Material And Methods: Prospective study was conducted on native PD without treatment (n = 25) and patients receiving levodopa (L-Dopa) (n = 25). Diffusion magnetic resonance-weighted imaging was done using a single-shot spin echo type of echo planar imaging. The apparent diffusion coefficient (ADC) value at different regions of the brain on both sides was calculated.
Results: The ADC value of the putamen in patients with native PD was 0.732 ± 0.15 × 10-3 mm2/seconds and in patients receiving levodopa was 0.789 ± 0.24 × 10-3 mm2/second. There was a statistically significant difference in the ADC value at the putamen (P = .001) between patients with native PD and patients receiving levodopa. When ADC value of the putamen at 0.745 × 10-3 mm2/second was used as a threshold value for differentiating native PD patients and patients receiving L-Dopa, the best results were obtained with an accuracy of 82%, sensitivity of 92%, specificity of 72%, positive predictive value of 77%, negative predictive value of 90%, and area under the curve of 0.955.
Conclusion: ADC value of the putamen is a promising parameter for predication of effect of levodopa on brain parenchyma in patients with PD.
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http://dx.doi.org/10.1016/j.acra.2010.08.023 | DOI Listing |
Ann Emerg Med
January 2025
Departments of Emergency Medicine & Population Health, New York University Grossman School of Medicine, New York, NY; Geriatric Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY.
Alzheimer's disease is the neurodegenerative disorder responsible for approximately 60% to 70% of all cases of dementia and is expected to affect 152 million by 2050. Recently, anti-amyloid therapies have been developed and approved by the Food and Drug Administration as disease-modifying treatments given as infusions every 2 to 5 weeks for Alzheimer's disease. Although this is an important milestone in mitigating Alzheimer's disease progression, it is critical for emergency medicine clinicians to understand what anti-amyloid therapies are and how they work to recognize, treat, and mitigate their adverse effects.
View Article and Find Full Text PDFJACC Clin Electrophysiol
January 2025
Vanderbilt Heart and Vascular Institute, Nashville, Tennessee, USA. Electronic address:
Background: Programmed electrical stimulation (PES) is an essential part of ventricular tachycardia (VT) ablation procedures, but VT is not always inducible, usually for reasons that are not clear.
Objectives: This study sought to review pacing site-specific failure of PES to induce scar-related VT and to provide a potential mechanistic explanation of the phenomena using a computer simulation.
Methods: Six patients in whom aggressive PES from traditional RV pacing sites failed to induce VT, but VT was easily inducible from a nontraditional site, were reviewed.
JACC Heart Fail
January 2025
Division of Cardiology, CardioVascular Center, Tufts Medical Center, Boston, Massachusetts, USA; Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address:
J Hand Surg Am
January 2025
Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO. Electronic address:
Purpose: Isolated coronal shear fractures of the distal humerus in adolescents are rare injuries with unique surgical challenges. Respect for the posterior blood supply, open physes, and need for direct visualization to achieve anatomic reduction are critical considerations in surgical fixation. This study presents a case series and a surgical approach used in treating these patients.
View Article and Find Full Text PDFJ Hand Surg Am
January 2025
Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia; Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA. Electronic address:
Purpose: Acute hand infections (AHIs) remain a challenge for hand surgeons and represent a condition for which clinical outcomes are considerably affected by social barriers. We previously described the looped Penrose drainage technique, where a drain is sutured to itself in a loop and the outflow tract of egress is maintained, thus obviating the need for large incisions, wound closure, or repeat packing, thereby reducing the follow-up burden. In the face of escalating numbers of socioeconomically vulnerable patients, especially in urban settings, we aimed to characterize the clinical features and outcomes of this technique in an urban population of patients with AHI.
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