- Atlanta, Georgia, United States
Carolyn Meltzer
Emory University, Radiology and Imaging Sciences, Faculty Member
Introduction Functional imaging of narcolepsy type 1 (NT1) has shown disparate results, with evidence for both regional hyper- and hypo-metabolism. A FDG-PET study of idiopathic hypersomnia (IH) demonstrated regional hypermetabolism... more
Introduction Functional imaging of narcolepsy type 1 (NT1) has shown disparate results, with evidence for both regional hyper- and hypo-metabolism. A FDG-PET study of idiopathic hypersomnia (IH) demonstrated regional hypermetabolism within the salience network. Methods Patients with NT1 (n=14) or IH (n=16) were recruited, with age-matched, non-sleepy controls (HC, n=8). Patients discontinued treatment for ≥5 half-lives. Participants underwent injection of 18F-fludeoxyglucose (FDG) in a dimly-lit room and were asked to remain awake, seated quietly. Simultaneous 6-channel EEG, EOG, and EMG were collected. Participants were alerted by a loud noise if sleep onset was observed. Thirty minutes after injection, patients underwent 36-minute PET scan. Images were spatially normalized to MPRAGE images and analyzed for group differences using SPM8. Results Groups were similar in age (NT1: 30.0 (+/-SD 8.3), IH: 36.3 (+/-12.4), HC: 33.2 (+/-16.2), p=0.29) and gender (%women, NT1: 71%, IH: 87.5%,...
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A dearth of women leaders in the field of radiology and affiliated industries persists despite a recognition of the importance, value, and impact that would derive from its rectification. A targeted educational collaboration, described... more
A dearth of women leaders in the field of radiology and affiliated industries persists despite a recognition of the importance, value, and impact that would derive from its rectification. A targeted educational collaboration, described herein, was established between academia and industry to address this deficit and to facilitate the placement of highly qualified women into leadership positions. The actionable platform offered has the potential to narrow the gap for underrepresented groups in professional leadership positions.
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La mejora en los procedimientos de las tecnicas neurorradiologicas in vivo para la investigacion de la estructura y el funcionamiento del cerebro de los individuos mayores ha permitido profundizar en el conocimiento de los fundamentos... more
La mejora en los procedimientos de las tecnicas neurorradiologicas in vivo para la investigacion de la estructura y el funcionamiento del cerebro de los individuos mayores ha permitido profundizar en el conocimiento de los fundamentos biologicos del envejecimiento normal y de las alteraciones psiquiatricas y neurologicas caracteristicas de la edad avanzada. Mientras que los estudios posmortem se centran en las ultimas etapas de una enfermedad, las tecnicas de imagen funcionales y estructurales nos han permitido caracterizar los cambios que tienen lugar en el cerebro durante las primeras fases de la enfermedad de Alzheimer (EA). El desarrollo de tecnicas terapeuticas mas eficaces, que pueden enlentecer y, potencialmente, invertir el avance de la enfermedad, ha hecho que las tecnicas basadas en la resonancia magnetica sean una herramienta fundamental para detectar el estado preclinico de la EA. Por tanto, el uso de procedimientos no invasivos para identificar el deterioro cognitivo leve (DCL), considerado un estadio transitorio entre el envejecimiento normal y la EA, es un objetivo de una importancia fundamental para la salud publica mundial. En este articulo haremos una revision de las nuevas estrategias de neuroimagen que pueden emplearse para diagnosticar el DCL.
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ABSTRACT
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LEARNING OBJECTIVES View learning objectives under main course title.
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The structural organization of the dura and leptomeninges is reflected in its magnetic resonance (MR) imaging appearance in normal and disease states. Two distinct enhancement patterns are characterized: dura-arachnoid enhancement and... more
The structural organization of the dura and leptomeninges is reflected in its magnetic resonance (MR) imaging appearance in normal and disease states. Two distinct enhancement patterns are characterized: dura-arachnoid enhancement and pia-subarachnoid space enhancement. The dura-arachnoid pattern consists of curvilinear enhancement overlying the brain and immediately deep to the inner table of the calvaria, as well as along the falx and tentorium. Pial enhancement closely follows the brain surface into sulci and outlines the basal cisterns. Recognition of these enhancement patterns and other MR imaging characteristics may enhance the role of MR imaging in the detection, diagnosis, and follow-up of neoplastic and nonneoplastic disorders affecting the meninges. The focus of this article (Part I) is the MR appearance of the normal meninges and nonneoplastic causes of meningeal disease. Part II of this series will discuss neoplastic conditions affecting the coverings of the brain and spinal cord with an emphasis on pathways of disease spread.
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LEARNING OBJECTIVES 1) Identify the different grant mechanisms available within the NIH and the requirements for submitting to a particular mechanism. 2) List the criteria used in the evaluation of NIH grants and what happens prior to and... more
LEARNING OBJECTIVES 1) Identify the different grant mechanisms available within the NIH and the requirements for submitting to a particular mechanism. 2) List the criteria used in the evaluation of NIH grants and what happens prior to and during a study section review meeting. 3) Articulate the benefits of being a reviewer for the NIH and the different ways that one can be a reviewer. 4) Observe a mock study section presented by the NIH with experienced reviewers evaluating at least two grant mechanisms. ABSTRACT This workshop designed to provide information to radiologists and imaging scientists interested in serving as expert peer reviewers on NIH and other grant study sections. Although a significant amount of information is available on how the review process works, many investigators (new and experienced) have questions that are best answered in person by those who have first-hand experience. Attendees will be provided with a clearer understanding of the review process, enablin...
LEARNING OBJECTIVES 1) How to produce patient education videos. 2) How to deploy them in a patient care setting. 3) How to measure the impact on patient satisfaction.
Research Interests: Dementia, Epilepsy, Positron Emission Tomography, Medicine, Tomography, and 11 moreEnergy Metabolism, Humans, Blood Glucose, Brain Ischemia, Clinical Sciences, Single Photon Emission Computed Tomography, Psychotic Disorders, Neurosciences, Brain Neoplasms, Brain Diseases, and Postoperative Complications
Monozygotic (MZ) or "identical" twins arise from a single fertilized egg, which divides into two embryos at an early stage of development. As a result, MZ twins have identical genomes and are always of the same sex. A case of... more
Monozygotic (MZ) or "identical" twins arise from a single fertilized egg, which divides into two embryos at an early stage of development. As a result, MZ twins have identical genomes and are always of the same sex. A case of optic nerve hypoplasia and anisometropia, in association with mirror-image presentation in a set of 12-year-old identical twins, is reported. The monozygotic twinning event responsible for identical twins--as well as the rare phenomenon of mirror imaging--is described. The combined occurrence of anisometropia and optic nerve hypoplasia in mirror-image presentation in a set of monozygotic twins provides a unique opportunity to study the genetic versus environmental influences on the development of optic nerve hypoplasia. Although the cause of optic nerve hypoplasia remains unclear, its associated mirror-image presentation in this case suggests a possible genetic predisposition.
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Laboratory studies have established the potential for neuronal transplantation to be of benefit to patients. Experimental studies in normal animals indicate that brain implantation of neurons seems safe. Implanted neurons integrated with... more
Laboratory studies have established the potential for neuronal transplantation to be of benefit to patients. Experimental studies in normal animals indicate that brain implantation of neurons seems safe. Implanted neurons integrated with the host brain, sent out axonal processes to communicate with other nerve cells, released transmitters (the chemical messengers of nerve cell communication), and demonstrated typical neuronal proteins. This article discusses phase I and II trials of neuronal transplantation in humans with small strokes in critical brain locations such as the basal ganglia region. More work is needed to confirm safety and to identify optimal measures of efficacy in this setting.
Research Interests: Neuroscience, Medicine, Transplantation, Stroke, Humans, and 8 moreFemale, Male, Motor Cortex, Two Stroke Engine, Aged, Middle Aged, Adult, and Basal ganglia
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The aggressiveness of head and neck cancer and the associated high rate of tumor recurrence and treatment-related morbidity emphasize the importance of early and accurate clinical evaluation and patient monitoring strategies. As combined... more
The aggressiveness of head and neck cancer and the associated high rate of tumor recurrence and treatment-related morbidity emphasize the importance of early and accurate clinical evaluation and patient monitoring strategies. As combined PET-CT imaging has evolved to become a valuable tool in the diagnostic and prognostic assessment of cancer patients, it is clear that among its most useful roles is the role it plays in imaging head and neck tumors. Due to the complexity of anatomy in the head and neck, variability of physiologic FDG uptake in normal tissues, and the inherent difficulty in interpreting posttreatment changes with conventional anatomic imaging or FDG PET alone, PET-CT imaging has developed a useful niche for both primary assessment and therapeutic monitoring of head and neck cancer. Increasing clinical experience confirms both improved reader confidence and diagnostic accuracy with PET-CT relative to single-modality approaches, particularly in squamous cell carcinomas. However, the widespread use of PET-CT in head and neck tumor imaging necessitates an awareness of the unique artifacts that may result from CT-based attenuation correction and careful attention to details of image acquisition and processing.
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To correlate the magnetic resonance (MR) imaging features of and histologic findings in Lhermitte-Duclos disease (LDD) (dysplastic gangliocytoma). MR imaging and histologic data from eight patients with the diagnosis of LDD were... more
To correlate the magnetic resonance (MR) imaging features of and histologic findings in Lhermitte-Duclos disease (LDD) (dysplastic gangliocytoma). MR imaging and histologic data from eight patients with the diagnosis of LDD were retrospectively reviewed. Gross pathologic specimens were also available in one case. Contrast material-enhanced MR images were obtained in seven of the eight patients. At MR imaging, a non-enhancing mass in the cerebellar hemisphere was characterized by a striated pattern of hyperintensity on T2-weighted images and corresponding hypointensity on T1-weighted images, which represented the abnormally thickened folia. None of the masses demonstrated enhancement. Most other cerebellar masses destroy the folial pattern and show enhancement. The nonenhancing striated MR appearance of thickened folia in patients with LDD is distinctive and should suggest this diagnosis.
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Research Interests: Neuroscience, Neuroimaging, Behavior, Aging, Positron Emission Tomography, and 13 moreMedicine, Neurodegenerative Diseases, Affect, Brain Mapping, Brain, Humans, PET imaging, Human Brain, Single Photon Emission Computed Tomography, Radiopharmaceuticals, Brain Function, Brain Aging, and Neurotransmitter systems
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Functional imaging with positron emission tomography (PET) is playing an increasingly important role in the diagnosis and staging of malignant disease, image-guided therapy planning, and treatment monitoring. PET with the labeled glucose... more
Functional imaging with positron emission tomography (PET) is playing an increasingly important role in the diagnosis and staging of malignant disease, image-guided therapy planning, and treatment monitoring. PET with the labeled glucose analogue fluorine 18 fluorodeoxyglucose (FDG) is a relatively recent addition to the medical technology for imaging of cancer, and FDG PET complements the more conventional anatomic imaging modalities of computed tomography (CT) and magnetic resonance imaging. CT is complementary in the sense that it provides accurate localization of organs and lesions, while PET maps both normal and abnormal tissue function. When combined, the two modalities can help both identify and localize functional abnormalities. Attempts to align CT and PET data sets with fusion software are generally successful in the brain; other areas of the body is more challenging, owing to the increased number of degrees of freedom between the two data sets. These challenges have recently been addressed by the introduction of the combined PET/CT scanner, a hardware-oriented approach to image fusion. With such a device, accurately registered anatomic and functional images can be acquired for each patient in a single scanning session. Currently, over 800 combined PET/CT scanners are installed in medical institutions worldwide, many of them for the diagnosis and staging of malignant disease and increasingly for monitoring of the response to therapy. This review will describe some of the most recent technologic developments in PET/CT instrumentation and the clinical indications for which combined PET/CT has been shown to be more useful than PET and CT performed separately.
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Neuroimaging studies of impulsive-aggressive subjects with borderline personality disorder (BPD) demonstrate hypometabolism in areas of prefrontal and frontal cortex, and a blunted cortical metabolic response to challenge with... more
Neuroimaging studies of impulsive-aggressive subjects with borderline personality disorder (BPD) demonstrate hypometabolism in areas of prefrontal and frontal cortex, and a blunted cortical metabolic response to challenge with serotonergic agonists. Neuroendocrine responses to serotonergic challenge are known to vary greatly by gender, and may be related to sex differences in expression of impulsive aggression. We conducted single-blind, placebo-controlled fenfluramine-activated positron emission tomography (PET) studies in impulsive male and female subjects with BPD to look for gender differences in cortical response. The sample comprised 22 BPD (15 female, 7 male) and 24 control subjects (10 female, 14 male) who received placebo on Day 1 and d,l-fenfluramine on Day 2 before PET neuroimaging. In response to placebo, female, but not male, controls had areas of increased uptake of fluorodeoxyglucose-F18 in prefrontal cortex compared with BPD subjects, with greatest uptake in the medial orbital frontal cortex, bilaterally. Male, but not female, BPD subjects, showed areas of increased glucose utilization compared with controls in large areas of parietal and occipital cortex, bilaterally. In response to fenfluramine (relative to placebo), significant decreases in glucose uptake were found in male, but not female, BPD subjects, centered in the left temporal lobe. Female, but not male, control subjects showed significantly decreased uptake in areas of right frontal and temporal cortex. Covarying for impulsive-aggression rendered nonsignificant the gender differences in responses to placebo or fenfluramine. Gender differences in serotonergic function may mediate differences in behavioral expression of impulsive aggression in subjects with BPD.
Research Interests: Cognitive Science, Psychiatry, Borderline Personality Disorder, Positron Emission Tomography, Medicine, and 15 morePrefrontal Cortex, Brain, Humans, Internal Medicine, Placebo, Aggression, Female, Male, Gender Difference, Frontal Cortex, Clinical Sciences, Glucose Uptake, Neurosciences, Fenfluramine, and Medical and Health Sciences
Research Interests: Cognitive Science, Neurology, Cognition, Aging, Medicine, and 15 moreBrain, Humans, Female, Male, Acetylcholine, Clinical Sciences, Aged, Disease Progression, Cerebrovascular Disorders, Neurosciences, Anticholinergic, Cognition disorders, Cerebral Infarction, Psychomotor Performance, and Neuropsychological Tests
Functional interactions between the medial prefrontal cortex (mPFC) and amygdala play a key role in regulating emotional behaviors. Though serotonin (5-HT) is broadly involved in modulating this functional circuitry, the 5-HT receptors... more
Functional interactions between the medial prefrontal cortex (mPFC) and amygdala play a key role in regulating emotional behaviors. Though serotonin (5-HT) is broadly involved in modulating this functional circuitry, the 5-HT receptors mediating this neuromodulation are unclear. Postsynaptic 5-HT1A receptors are expressed on both excitatory and inhibitory mPFC neurons. Their relative contribution to functional variability may be dependent upon the magnitude of 5-HT release, which is regulated partly by somatodendritic 5-HT1A autoreceptors. Using multimodal neuroimaging data, we determined the effects of 5-HT1A autoreceptor binding and mPFC 5-HT1A receptor binding (using PET), on functional connectivity of the amygdala and mPFC during the processing of threat (using BOLD fMRI). Furthermore, we determined whether 5-HT1A autoreceptor binding moderated the association between mPFC 5-HT1A receptor binding and functional connectivity. 5-HT1A receptor binding was assessed using [C]WAY 100635 PET (90 minute scan session) in 42 healthy adult volunteers (20M, age=39±13). Regional binding potential (BPND) in the dorsal raphe nuclei (DRN), pregenual and subgenual prefrontal cortices (pg/sgPFC) was determined using the Logan graphical analysis method. Functional connectivity between the amygdala and mPFC was calculated from BOLD fMRI data collected during the perceptual processing of threat-related expressions. Associations between regional BPND and functional connectivity were identified using the GLM within SPM2. Additional statistical analyses were carried out in SPSS 17.0 on data extracted from SPM2. Mean binding potential within DRN, pgPFC and sgPFC were 3.50±1.33, 4.47±1.09 and 4.88±1.34 (mean±s.d.), respectively. We observed clusters within mPFC whose functional connectivity with the amygdala was significantly positively associated with pgPFC and sgPFC 5-HT1A BPND. No clusters were significantly associated with DRN 5-HT1A BPND. We identified a large cluster within mPFC where the association between functional connectivity and prefrontal BPND was significantly moderated by DRN 5-HT1A autoreceptor BPND (DRN 5-HT1A BPND×pgPFC 5-HT1A BPND interaction effect on functional connectivity: t=−3.06, r=0.24, p=0.004; DRN 5-HT1A BPND×sgPFC 5-HT1A BPND interaction effect on functional connectivity: t=−2.34, r=0.15, p=0.024). The nature of this interaction is consistent with a positive association between mPFC 5-HT1A and functional connectivity when DRN 5-HT1A is low, but the opposite pattern when DRN 5-HT1A is high. Our results suggest that postsynaptic prefrontal 5-HT1A contributes to variability in amygdala–mPFC functional connectivity. Furthermore, the data reveal that this association is modulated by 5-HT1Aautoreceptor levels. Given the expression of 5-HT1A receptors on both excitatory and inhibitory prefrontal neuronal populations, the current data suggest that 5-HT1A receptors on excitatory neurons are relatively more proximal to synapses, through which they contribute to a reduction in amygdala–prefrontal functional connectivity when 5-HT1A autoreceptor levels are relatively high and 5-HT signaling is relatively low. In contrast, prefrontal 5-HT1A receptors on inhibitory neurons may be relatively extrasynaptic, and thus contribute to the effects of 5-HT1A signaling on this corticolimbic circuit when 5-HT1Aautoreceptor levels are relatively low and 5-HT signaling is relatively high.
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Research Interests: Physiology, Nuclear medicine, Positron Emission Tomography, Medicine, Pancreatic Cancer, and 14 moreColorectal cancer, Lung Cancer, Renal Cancer, Image fusion, Attenuation Correction, PET imaging, Head and Neck Cancer, Ct Scan, Clinical Sciences, Three Dimensional, Whole Body, Region of Interest, Solitary pulmonary nodule, and Whole Body Imaging
We read with interest the results of the ACR 2013 workforce survey on the current state and short-term future prospects for radiologist employment [1]. The relatively depressed radiology jobmarket, which promises to be flat over the next... more
We read with interest the results of the ACR 2013 workforce survey on the current state and short-term future prospects for radiologist employment [1]. The relatively depressed radiology jobmarket, which promises to be flat over the next 3 years, suggests that we should reconsider, and possibly decrease, the number of radiology residency positions in the United States. Perhaps we are training too many radiologists at a time when the imaging volume growth curve has flattened.
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A valid quantitative imaging method for the measurement of amyloid deposition in humans could improve Alzheimer's disease (AD) diagnosis and antiamyloid therapy assessment. Our group developed Pittsburgh Compound-B (PIB), an... more
A valid quantitative imaging method for the measurement of amyloid deposition in humans could improve Alzheimer's disease (AD) diagnosis and antiamyloid therapy assessment. Our group developed Pittsburgh Compound-B (PIB), an amyloid-binding radiotracer, for positron emission tomography (PET). The current study was aimed to further validate PIB PET through quantitative imaging (arterial input) and inclusion of subjects with mild cognitive impairment (MCI). Pittsburgh Compound-B studies were performed in five AD, five MCI, and five control subjects and five subjects were retested within 20 days. Magnetic resonance images were acquired for partial volume correction and region-of-interest definition (e.g., posterior cingulate: PCG; cerebellum: CER). Data were analyzed using compartmental and graphical approaches. Regional distribution volume (DV) values were normalized to the reference region (CER) to yield DV ratios (DVRs). Good agreement was observed between compartmental and Loga...
Research Interests: Kinetics, Magnetic Resonance Imaging, Medicine, Amyloid, Humans, and 15 moreFemale, Male, Amyloid Beta, Clinical Sciences, Aged, Cerebral, Adult, Memory Disorders, Cerebellar Cortex, Alzheimer Disease, Area of Interest, aniline Compounds, Magnetic resonance image, Cardiovascular medicine and haematology, and Kinetic model
Research Interests: Psychology, Cognitive Science, Implicit learning, Cognition, Magnetic Resonance Imaging, and 15 moreMedicine, Learning, Brain, Humans, Reaction Time, Sequence Learning, Serial Reaction Time, Clinical Sciences, Geriatric Psychiatry, Aged, White matter, Analysis of Variance, Older Adult, Cerebrovascular Disorders, and White Matter Hyperintensities
Research Interests: Radiology, Nuclear medicine, Positron Emission Tomography, Medicine, Humans, and 15 moreFemale, Male, Esophageal Cancer, Clinical Sciences, Middle Aged, Oral Squamous Cell Carcinoma (OSCC), Single Photon Emission Computed Tomography, Retrospective Studies, Radiopharmaceuticals, Sensitivity and Specificity, X ray Computed Tomography, Adenocarcinoma, Fluorodeoxyglucose, Neoplasm staging, and minimally invasive surgical procedures
Methods [Carbonyl-11C] WAY 100635 PET was acquired prior to initiation of therapy in 21 patients with untreated (non-psychotic, non-bipolar) major depression (6M: 15F; mean age: 71. 7 plusminus 5.7), and 17 healthy control subjects (8M:... more
Methods [Carbonyl-11C] WAY 100635 PET was acquired prior to initiation of therapy in 21 patients with untreated (non-psychotic, non-bipolar) major depression (6M: 15F; mean age: 71. 7 plusminus 5.7), and 17 healthy control subjects (8M: 9F; mean age: 69.5 plusminus ...
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Research Interests: Metabolism, Electroencephalography, Positron Emission Tomography, Medicine, Brain Mapping, and 15 moreHumans, Glucose, Glucose Metabolism, Cerebral Cortex, Female, Male, Depressive Disorder, Arousal, Adult, Parietal Lobe, Neuroscience of Sleep, Archives General Psychiatry, Frontal Lobe, Functional Laterality, and Medical and Health Sciences
ABSTRACT
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The authors describe the establishment of a radiology residency research track at their institution. Based on growing biomedical technology needs and the tremendous increase in imaging-based research, the importance of training and... more
The authors describe the establishment of a radiology residency research track at their institution. Based on growing biomedical technology needs and the tremendous increase in imaging-based research, the importance of training and cultivating future clinical investigators continues to grow. Within the framework of a supportive environment, a residency research track exposes motivated radiologists-in-training to the tools, challenges, and successes of a career in academics. The authors describe their program's design, admissions process, curriculum, and expectations. Lastly, the authors share the insight of their experience and seek feedback from readers who have been involved in similar endeavors.
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Research Interests: Psychiatry, Magnetic Resonance Imaging, Medicine, Hippocampus, Brain, and 15 moreHumans, Female, Male, American Journal of Psychiatry, American, Depressive Disorder, Aged, Entorhinal Cortex, Age Factors, Geriatric Assessment, Age of Onset, Hippocampal formation, Functional Laterality, Psychiatric Status Rating Scales, and Medical and Health Sciences
Women with chest pain in the absence of obstructive coronary artery disease (CAD) frequently have coronary microvascular dysfunction and inducible myocardial ischemia. Microvascular dysfunction is commonly diagnosed by demonstrating... more
Women with chest pain in the absence of obstructive coronary artery disease (CAD) frequently have coronary microvascular dysfunction and inducible myocardial ischemia. Microvascular dysfunction is commonly diagnosed by demonstrating abnormal flow reserve in a single coronary artery during angiography. Therefore, diagnostic accuracy is dependent on homogeneity of microvascular dysfunction in the myocardium. In the Women's Ischemia Syndrome Evaluation (WISE), 34 women with chest pain and no significant CAD and 9 female control subjects underwent 13N-NH3 positron emission tomography to measure adenosine-induced changes in myocardial perfusion (ie, coronary flow reserve [CFR]). Flow reserve was correlated among the left anterior descending (LAD), circumflex (LCx), and right (RCA) coronary artery distributions. The mean CFR in the LAD, LCx, and RCA was 2.85 +/- 1.35, 2.58 +/- 0.94, and 3.24 +/- 1.42, respectively. Concordance in the classification of microvascular function as normal (CFR > or =2.5) versus abnormal was present in the LAD and RCA, LAD and LCx, and RCA and LCx distributions in only 71.8%, 66.7%, and 61.6% of patients, respectively. There was a modest degree of correlation of CFR between the LAD and RCA (r = 0.79, P <.001), LAD and LCx (r = 0.61, P <.001), and LCx and RCA (r = 0.57, P <.001). Comparison of CFR in the 3 coronary arteries simultaneously in all patients demonstrated that the LCx had values that were significantly lower than the RCA and LAD distributions. Substantial discordance of classification of microvascular function among coronary artery distributions in women with chest pain and no CAD suggests that microvascular dysfunction is distributed heterogeneously in the myocardium. Assessment of CFR in a single coronary artery during cardiac catheterization may not provide an accurate assessment of the coronary microcirculation in women with chest pain not attributable to CAD.
Research Interests: Cardiology, Microcirculation, Medicine, Heterogeneity, Clinical Practice, and 15 moreAdenosine, Humans, Internal Medicine, Female, Cardiac Catheterization, Coronary Circulation, Diagnostic Accuracy, Coronary Artery Disease, Circumflex, Chest Pain, Case Control Studies, Coronary Flow Reserve, Coronary artery, Cardiovascular medicine and haematology, and Fractional Flow Reserve
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This study examined whether the severity of cerebral white matter abnormalities (evident on MR images as white matter hyperintensities (WMH)) was related to the cognitive performance of 141 high-functioning older adults. The elderly... more
This study examined whether the severity of cerebral white matter abnormalities (evident on MR images as white matter hyperintensities (WMH)) was related to the cognitive performance of 141 high-functioning older adults. The elderly showed the typical age decrement on measures of processing speed, working memory, and inhibition; however WMH severity was significantly related only to processing speed. The strength of this relationship was, however, influenced by the educational level of the participants, such that processing speed was more associated with WMH severity in less-educated than in well-educated participants. This is consistent with recent concepts of cognitive reserve, but does raise a question as to the underlying source of the cognitive decrement found in the sort of well-educated elders typically used in cognitive-aging studies.
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This report describes our initial experience using positron emission tomography (PET) scanning in esophageal cancer patients. In two patients PET identified distant metastatic disease missed by conventional staging. Laparoscopic biopsy... more
This report describes our initial experience using positron emission tomography (PET) scanning in esophageal cancer patients. In two patients PET identified distant metastatic disease missed by conventional staging. Laparoscopic biopsy provided histological confirmation of metastases. In the third patient, locoregional lymph nodes were identified by PET and confirmed by surgical staging. In this preliminary report, PET appears to be a promising new noninvasive modality for staging patients with esophageal cancer.
Research Interests: Positron Emission Tomography, Medicine, Biopsy, Complication, Humans, and 15 moreMale, Distal, Esophageal Cancer, Clinical Sciences, Association, Aged, Middle Aged, Lymph Node, Minimally Invasive, Laparoscopy, Adenocarcinoma, lumbar vertebrae, Neoplasm staging, Liver neoplasms, and minimally invasive surgical procedures
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Supplemental material, MSJ913977_supplemental_table for Patient-reported financial toxicity in multiple sclerosis: Predictors and association with care non-adherence by Gelareh Sadigh, Neil Lava, Jeffrey Switchenko, Richard Duszak,... more
Supplemental material, MSJ913977_supplemental_table for Patient-reported financial toxicity in multiple sclerosis: Predictors and association with care non-adherence by Gelareh Sadigh, Neil Lava, Jeffrey Switchenko, Richard Duszak, Elizabeth A Krupinski, Carolyn Meltzer, Danny Hughes and Ruth C Carlos in Multiple Sclerosis Journal
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Background: Multiple sclerosis (MS) results in considerable financial burdens due to expensive treatment and high rates of disability, which could both impact care non-adherence. Objective: To measure financial toxicity in MS patients,... more
Background: Multiple sclerosis (MS) results in considerable financial burdens due to expensive treatment and high rates of disability, which could both impact care non-adherence. Objective: To measure financial toxicity in MS patients, identify its predictors and association with care non-adherence. Methods: Adult MS patients visiting neurology clinic (June 2018 to February 2019) were consented to complete a survey. Financial toxicity was measured using Comprehensive Score for Financial Toxicity (COST) (range: 0–44, the lower the score, the worse the financial toxicity). Independent predictors of financial toxicity were identified using linear regression. Associations of COST score with patient outcomes were assessed. Results: The mean COST score in 243 recruited patients was 17.4 ± 10.2. In response to financial burdens, 66.7% and 34.7% reported life-style altering behaviors or care non-adherence, respectively. Higher financial self-efficacy was associated with less financial toxic...