Structural imaging findings on non-enhanced computed tomography are severely underreported in the primary care diagnostic work-up of subjective cognitive decline

Abstract

Purpose

The purpose of this study was to investigate how structural imaging findings of medial temporal lobe atrophy (MTA), posterior cortical atrophy (PCA), global cortical atrophy (GCA), white matter changes (WMC), and Evans' index/width of lateral ventricles (EI/WLV) are reported in the primary care diagnostic work-up of patients with subjective cognitive decline or mild cognitive impairment.

Methods

We included 197 patients referred to a non-enhanced computed tomography (NECT) as part of the diagnostic work-up. We compared the frequencies of reported findings in radiology reports written by neuroradiologists and general radiologists with actual pathological findings in a second view done by a single neuroradiologist using the MTA, PCA, GCA, WMC, and EI/WLV visual rating scales. Structural findings were also compared to cognitive tests.

Results

We found that MTA and PCA were clearly underreported by both neuroradiologists and general radiologists. The presence of GCA and WMC was also underreported among general radiologists. Only MTA showed a clear association with cognitive test results.

Conclusions

We believe that the use of visual rating scales should be put into clinical practice to increase the yield of clinical NECT exams in the investigation of cognitive impairment. Special emphasis should be put on reporting MTA.

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Complete bilateral Tessier’s facial cleft number 5: surgical strategy for a rare case report

Abstract

The oro-ocular cleft number 5 according to the Tessier classification is one of the rarest facial clefts and few cases have been reported in the literature. Although the detailed structure of rare craniofacial clefts is well established, the cause of these pathological conditions is not. There are no existing guidelines for the management of this particular kind of cleft. We describe the case of a 19-month-old girl with a complete bilateral facial cleft. We describe the surgical steps taken to achieve the primary correction of the soft tissue deformation. Embryologic development and radiological approach are discussed, as are also the psychological and social aspects of severe facial deformities.

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Complete bilateral Tessier’s facial cleft number 5: surgical strategy for a rare case report

Abstract

The oro-ocular cleft number 5 according to the Tessier classification is one of the rarest facial clefts and few cases have been reported in the literature. Although the detailed structure of rare craniofacial clefts is well established, the cause of these pathological conditions is not. There are no existing guidelines for the management of this particular kind of cleft. We describe the case of a 19-month-old girl with a complete bilateral facial cleft. We describe the surgical steps taken to achieve the primary correction of the soft tissue deformation. Embryologic development and radiological approach are discussed, as are also the psychological and social aspects of severe facial deformities.

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Essential oils for fungal overgrowth

I've discussed the extremely important health condition, small intestinal bacterial overgrowth, or SIBO, a number of times, as it is present at epidemic proportions and for the most part not being diagnosed nor managed in conventional doctors' offices. The Wheat Belly and Undoctored lifestyles provide a powerful start in reversing this condition, but additional steps are often necessary. A number of people in our Undoctored Inner Circle, for instance, have identified their own SIBO and then managed it successfully with the help of our Virtual Meetup discussions, even after doctors advised them that there is no such thing, or it was stupid, or received other unhelpful responses. There is a related condition, intestinal fungal overgrowth, in which fungi proliferate, most commonly...

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CpV2Wx

Healthcare And Medicine Needs A Global FDA

Globalization reached healthcare big time: a French patient can easily ask a Belgian company to sequence the DNA of his tumor tissue, then convince a Swiss pharma company to sign them up for a relevant clinical trial on a Spanish island. Not only that but also the recent controversies around gene editing in babies in China, as well as the operation of direct-to-consumer genetic testing companies, the online medication scene, health technology companies expanding their services to other countries highlight the need for a global "FDA" day by day. We are not waiting for regulators The availability of know-how, raw materials, rapidly developing methods and technology entails the exponential growth of innovation everywhere – that also means the rigorously regulated healthcare and life sci...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RwVs7Y

Essential oils for fungal overgrowth

I've discussed the extremely important health condition, small intestinal bacterial overgrowth, or SIBO, a number of times, as it is present at epidemic proportions and for the most part not being diagnosed nor managed in conventional doctors' offices. The Wheat Belly and Undoctored lifestyles provide a powerful start in reversing this condition, but additional steps are often necessary. A number of people in our Undoctored Inner Circle, for instance, have identified their own SIBO and then managed it successfully with the help of our Virtual Meetup discussions, even after doctors advised them that there is no such thing, or it was stupid, or received other unhelpful responses. There is a related condition, intestinal fungal overgrowth, in which fungi proliferate, most commonly...

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CpV2Wx

Healthcare And Medicine Needs A Global FDA

Globalization reached healthcare big time: a French patient can easily ask a Belgian company to sequence the DNA of his tumor tissue, then convince a Swiss pharma company to sign them up for a relevant clinical trial on a Spanish island. Not only that but also the recent controversies around gene editing in babies in China, as well as the operation of direct-to-consumer genetic testing companies, the online medication scene, health technology companies expanding their services to other countries highlight the need for a global "FDA" day by day. We are not waiting for regulators The availability of know-how, raw materials, rapidly developing methods and technology entails the exponential growth of innovation everywhere – that also means the rigorously regulated healthcare and life sci...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RwVs7Y

Swollen lips after a night of partying-an allergic reaction to ecstasy? - Schr öder AS, Andresen-Streichert H, Anders S.

We describe the case of a young woman who underwent a forensic medical examination for suspected sexual assault. She claime... (Source: SafetyLit)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Mgf3Ds

New tools to diagnose Allergic Fungal Sinusitis (AFS) have the potential to reduce the need for surgery.

Thu, 01/17/2019 - 13:21News blog (Source: The Aspergillus Website - updates)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sw9WWy

Swollen lips after a night of partying-an allergic reaction to ecstasy? - Schr öder AS, Andresen-Streichert H, Anders S.

We describe the case of a young woman who underwent a forensic medical examination for suspected sexual assault. She claime... (Source: SafetyLit)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Mgf3Ds

New tools to diagnose Allergic Fungal Sinusitis (AFS) have the potential to reduce the need for surgery.

Thu, 01/17/2019 - 13:21News blog (Source: The Aspergillus Website - updates)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sw9WWy

Swollen lips after a night of partying-an allergic reaction to ecstasy? - Schr öder AS, Andresen-Streichert H, Anders S.

We describe the case of a young woman who underwent a forensic medical examination for suspected sexual assault. She claime... (Source: SafetyLit)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Mgf3Ds

Swollen lips after a night of partying-an allergic reaction to ecstasy? - Schr öder AS, Andresen-Streichert H, Anders S.

We describe the case of a young woman who underwent a forensic medical examination for suspected sexual assault. She claime... (Source: SafetyLit)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Mgf3Ds

New tools to diagnose Allergic Fungal Sinusitis (AFS) have the potential to reduce the need for surgery.

Thu, 01/17/2019 - 13:21News blog (Source: The Aspergillus Website - updates)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sw9WWy

Association of Genetic vs Environmental Factors in Swedish Adoptees With Clinically Significant Tinnitus

This study uses Swedish national registry data to assess the association between genetic vs environmental factors and risk of tinnitus among adoptees.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SZNFfv

Health-Related Quality of Life After Diagnosis and Treatment of Differentiated Thyroid Cancer

This content analysis assesses health-related quality of life outcomes and adverse effects of different types of surgical treatment of differentiated thyroid cancer among patients in an Australian case-control study.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ATMxmF

Heritability and Tinnitus

Genetic factors are fundamental in the molecular pathologic mechanisms of a number of auditory disorders that present throughout the lifespan. Historically, an understanding of the role of genetics in tinnitus has not been as straightforward because it can be viewed as a symptom of multiple diseases. Risk factors for tinnitus include hearing loss, aging, and noise exposure, most logically connecting its cause with environmental factors. This notion has been supported by a lack of heritability determined from early family-based questionnaire studies. In addition, previous studies that have primarily used genotyping in the pregenomics era have identified several candidate genes implicated in tinnitus (summarized by Lopez-Escamez et al) that have thus far lacked replication, and a recent pilot genome-wide association study also did not reveal significant associations. Throughout the course of genetics research in tinnitus, it has become increasingly clear that the lack of significance may have been hampered by an underappreciation of the clinical heterogeneity and subtypes that are inherent in tinnitus, which may have profoundly clouded true significant associations.

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January Issue Highlights

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Iodine Deficiency and Hearing Impairment

To the Editor On June 7, 2018, Scinicariello et al published a study in JAMA Otolaryngology–Head & Neck Surgery in which they analyzed data from 1198 adolescents (aged 12-19 years) from NHANES 2007 to 2010, with urinary iodine, audiometric measurements, and demographic and related variables. The authors concluded that this is the first study in which it was demonstrated at a national level that a urinary iodine concentration (UIC) less than 100 μg/L was a predictive risk factor for having speech-frequency hearing loss (SFHL) among adolescents, and more specifically among those with UIC less than 50 μg/L.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Dfw5i1

Association of Age-Related Hearing Loss With Multiple Adverse Health Outcomes

Age-related hearing loss (ARHL) has recently received much attention owing to its recognition as a potential modifiable risk factor for dementia. An increasing number of observational studies, mostly published in the last decade, have associated ARHL with cognitive decline, cognitive impairment, and dementia, igniting increasing interest in ARHL. Livingston et al reported that interventions for peripheral hearing loss may reduce the prevalence of dementia by 9% globally, which is a result higher than that for any other modifiable risk factor. Interestingly, ARHL has also been associated with a higher risk for other common age-related conditions, including depression and falls, suggesting that ARHL is connected with a broader decline in health. However, the association of ARHL with adverse health outcomes other than dementia has been less well studied, despite the prevalence of ARHL as a chronic malady in older age (more than half of US adults older than 60 years have clinically meaningful hearing loss).

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