Assessment of Atherosclerosis in Ischemic Stroke by means of Ultrasound of Extracranial/Intracranial Circulation and Serum, Urine, and Tissue Biomarkers

It is a common practice to take into consideration age, diabetes, smoking, treated and untreated systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol for the prediction of atherosclerosis and stroke. There are, however, ultrasound markers in use for the assessment of atherosclerosis and the evaluation of stroke risk. Two areas of investigation are of interest: the carotid artery and the intracranial arterial circulation. Again, within the domain of the carotid artery, two ultrasonic markers have attracted our attention: intima media thickness of the carotid artery and the presence of carotid plaque with its various focal characteristics. In the domain of intracranial circulation, the presence of arterial stenosis and the recruitment of collaterals are considered significant ultrasonic markers for the above-mentioned purpose. On the other hand, a series of serum, urine, and tissue biomarkers are found to be related to atherosclerotic disease. Future studies might address the issue of whether the addition of proven ultrasonic carotid indices to the aforementioned serum, urine, and tissue biomarkers could provide the vascular specialist with a better assessment of the atherosclerotic load and solidify their position as surrogate markers for the evaluation of atherosclerosis and stroke risk.

Liquid biopsy of cerebrospinal fluid identifies neuronal pentraxin receptor (NPTXR) as a biomarker of progression of Alzheimer's disease

Background Alzheimer's disease (AD) is the most prevalent form of dementia. Currently, the most studied biomarkers of AD are cerebrospinal fluid (CSF) amyloid β 1-42, total tau and phosphorylated tau. However, misdiagnosis can exceed 20%. Recently, we found that CSF amyloid β precursor-like protein-1 (APLP1) and neuronal pentraxin receptor (NPTXR) are promising biomarkers of AD. The aim of the present study is to validate CSF APLP1 and NPTXR as biomarkers of AD severity. Methods APLP1 and NPTXR concentrations were measured in the CSF of patients with mild cognitive impairment (MCI) (n = 14), mild AD (n = 21), moderate AD (n = 43) and severe AD (n = 30) using enzyme-linked immunosorbent assays (ELISAs). Results CSF APLP1 and NPTXR were not associated with age or sex. CSF APLP1 was not different between any of the AD severity groups (p = 0.31). CSF NPTXR was significantly different between MCI and mild AD (p = 0.006), mild and moderate AD (p = 0.016), but not between moderate and severe AD (p = 0.36). NPTXR concentration progressively declined from MCI to mild, to moderate and to severe AD patients (p < 0.0001, Kruskal-Wallis test). CSF NPTXR positively correlated with the Mini-Mental Status Examination (MMSE) score (p < 0.001). Conclusions NPTXR concentration in CSF is a promising biomarker of AD severity and could inform treatment success and disease progression in clinical settings.

Elders and mental capacity: Using a qualitative approach to examine views on independence and protection across the Balkans

OBJECTIVE

How do people in contemporary Balkans think about elders and mental capacity, a particular medical and legal concept?

SUBJECTS AND METHODS

Different interpretations and applications regarding elders' mental capacity are explored through in-depth semi-structured interviews and field notes of 28 Greeks, 27 Bulgarians and 10 Romanians of varying ages, all living in Northern Greece. This study attempts to shed some light on the perceptions of ageing, mental disease, civil capacities, family and state involvement across three nearby nations. Interpretative phenomenological analysis (IPA), an approach to psychological qualitative research that aims to offer insights into how a given person, in a given context, makes sense of a given phenomenon was used for the first time applied to this topic.

RESULTS

Four areas for focus were formed, each relating to the elders and the aging process and presenting the associated themes drawn from the participants' accounts: 1) Discovering the altered-self of the elder, family and society, 2) General experience with old age and capacities in everyday life, 3) Ways of thinking and acting towards old age and capacity issues, and 4) Feelings and comparison thoughts towards old age and capacity issues. Education, occupation, life experience, and especially religious beliefs were all found to be involved in the ways that people from three cultural groups understand the concept of mental capacity and incapacity of elders in their everyday life. A main finding is that the more educated Bulgarians and Romanians tend to speak more easily and to be more positive towards the social construct of aging, while Greeks regardless of their gender, education, religious beliefs, and financial status, tend to consider in their narratives old age as equal to loss of mental capacity, which equals to loss of autonomy and total dependency on others. The process of old age for the group of Greeks begins with retirement which is perceived to reflect withdrawal from social life. This is primarily related to behaviors from individuals and society that result to deprivation of freedom.

CONCLUSION

The similarities and differences among these three ethnic groups are discussed, which according to the interviewees discourse reveal peculiar cultural understandings about subordinate themes such as power and its relationship to the self and superordinate themes on emotional control, choice, and individualism.