Our results suggest that HS is a frequent pathologic finding in community-based dementia. Individuals with HS have similar initial symptoms and rates of dementia progression to those with AD and therefore are frequently misclassified as having AD. Our clinical and pathologic findings suggest that HS has characteristics of a progressive disorder although the underlying cause remains elusive.
Despite the loss of locus ceruleus neurons in Alzheimer's disease, the aging-associated high concentration of CSF norepinephrine is retained in the earlier stages of Alzheimer's disease and increases further as the disease progresses. Increased brain noradrenergic activity may contribute to the agitated behaviors or cognitive deficits of patients with advanced Alzheimer's disease.
Pancreatic injury following penetrating trauma is a rare but complex problem in trauma surgery. The retroperitoneal location of the pancreas and its intricate anatomic relationship to other vital structures both contribute to this complexity. Accurate intraoperative diagnosis of pancreatic injury can be difficult, making careful and thorough operative exposure paramount. Operative management is guided by the presence of associated injuries and the severity of the pancreatic injury. External drainage, resection, and staged reconstruction when indicated are the pillars of operative management for the majority of injuries. Post-injury complications are common and can include fistula, pancreatitis, abscess, hemorrhage, and pseudocyst. ERCP is central to the management of these complications and can aid in avoiding return to the operating room. Because of the significant morbidity and mortality associated with penetrating pancreatic injury, collaboration among surgical disciplines is warranted to optimize outcome.
Families exist in which one or more persons meet both clinical and neuropathological criteria for DLB. They differ as to whether the signs of parkinsonism precede or follow signs of dementia. It remains to be determined whether this clinical distinction is biologically important. Susceptibility to developing LB pathology may be determined by the interaction between genetic predisposition and environmental risk factors.
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