Podcasts about Positron emission tomography

Gia-Raquel Rose, owner of Airs Above Yoga, LLC and a real estate sales associate in Tewksbury, New Jersey has had a love for horses stemming from early childhood. Growing up in “horse country” afforded her the privilege of beginning to ride from the tender age of four. It was a childhood illness, which brought her riding aspirations to an abrupt halt. It took twenty years before she was able to reunite with her long lost passion for horses and their ability to heal. In that time, she received a Bachelor of Arts in Corporate Communication from Arcadia University and became a twice two hundred hour certified yoga instructor in both Hatha and Vinyasa. It was the loss of her mother, Rose, to breast cancer, which ultimately shifted her trajectory from the corporate world to the internal work for which yoga, as a practice, is renowned. Jason DeSalvo co-founded Strategic Outpatient Services, Inc. in 1995, a company specializing in the development and management of outpatient Positron Emission Tomography centers, currently serving as the Company's CEO. Mr. DeSalvo has served on non-profit Boards including Ethos Farm Project, Coral Reef Alliance, Tewksbury Land Trust, Jazz House Kids and Hoop-A-Paluza; also serving as Vice Chairman of Montclair, New Jersey's Planning Board while a resident there. Mr. De Salvo holds a B.S. in Business Administration with Honors and Highest Distinction from the University of North Carolina at Chapel Hill and lives with his wife Deborah on Coldbrook Farm in Oldwick, New Jersey, where they regeneratively farm heirloom grains, fruits, nuts and vegetables. They have two wonderful adult children, Steven and Julia.

Today, I am joined by Jason and Deb DeSalvo of Cold Brook Farm. Jason is a serial entrepreneur who co-founded Strategic Outpatient Services, Inc. in 1995, a company specializing in the development and management of outpatient Positron Emission Tomography centers and is currently serving as the Company's CEO. Jason has served on non-profit Boards including Ethos Farm Project, Coral Reef Alliance, Tewksbury Land Trust, Jazz House Kids and Hoop-A-Paluza; also served as Vice Chairman of Montclair, New Jersey's Planning Board while a resident there. Deb is currently working as a farmer and gardener on their regenerative farm, Coldbrook Farm in Oldwick, NJ.  She is a member of the board of trustees for Raritan Headwaters Association, an organization protecting the 470-square mile watershed of the North and South branches of the Raritan River. Deb and Jason lived in Montclair for almost 30 years, where they raised their two children, Steven and Julia. While there, Deb worked as an environmental educator at Van Vleck House and Gardens and in the Montclair Public Schools.  She is a Master Gardener and for a short period of time baked in a local tea shop. Jason holds a Bachelor's in Business Administration with Honors and Highest Distinction from the University of North Carolina at Chapel Hill.  After getting a BA in English Literature and graduating Summa Cum Laude from Hunter College in NYC, Deb was a traffic associate at 1010 WINS radio and traffic manager at Bloomberg News Radio. She left that career behind to become a stay-at-home mom. Jason and Deb live in Oldwick, New Jersey, where they regeneratively farm heirloom grains, fruits, nuts and vegetables.  To connect with Deb and Jason: https://coldbrookfarmnj.com/ Instagram: https://www.instagram.com/coldbrookfarm/ Mentioned in this episode: Ethos Health, Farm Project, Dr. Ron Weiss Nutritionfacts.org TrueNorth Health Center Double Zero NYC Doug Lisle Homegrown National Park Raritan Headwaters NJ Audubon NJ Senator Cory Booker To connect with me:Follow me on Facebook and Instagram @didyoubringthehummus Join my mailing list and get 3 free recipes just for signing up! https://www.didyoubringthehummus.com/3recipepdf Join my Podcast Fan Facebook Group: https://www.facebook.com/groups/didyoubringthehummus/ Book a free 30 minute call with me: https://www.didyoubringthehummus.com/book-online To be a guest on the podcast: https://www.didyoubringthehummus.com/beaguest ©2024 Kimberly Winters - Did You Bring the Hummus LLC Theme Song ©2020 JP Winters ⁠@musicbyjpw⁠ --- Send in a voice message: https://podcasters.spotify.com/pod/show/kimberly-winters/message

Another huge month in European Urology and we bring you selected highlights here on the European Urology podcast. Co-hosts Professor Declan Murphy (Melbourne) and Dr Joyce Baard (Amsterdam) highlight two key papers (details below) from this month's journal, including interviews with key authors and expert commentators. We also look at other highlights in this month's journal with Dr Nikita Bhatt. Plus Declan was in Milan recently and sat down with current and past Editors-in-Chief, Professor Alberto Briganti and Professor Francesco Montorsi to have a chat. Even better on our YouTube channelPodcast Priority Papers1. A Detailed Evaluation of the Effect of Prostate-specific Antigen–based Screening on Morbidity and Mortality of Prostate Cancer: 21-year Follow-up Results of the Rotterdam Section of the European Randomised Study of Screening for Prostate Cancer Featured author - Professor Monique Roobol (Rotterdam)Discussant - Professor Peter Albers (Dusseldorf)2. Diagnostic Performance and Safety of Positron Emission Tomography with 18F-rhPSMA-7.3 in Patients with Newly Diagnosed Unfavourable Intermediate- to Very-high-risk Prostate Cancer: Results from a Phase 3, Prospective, Multicentre Study (LIGHTHOUSE) Featured author - Dr Tobias Maurer (Hamburg)Discussant - Professor Stefano Fanti (Bologna)

Welcome to the 11th episode of The Brain Podcast - the official podcast of the journals Brain and Brain Communications. In this episode we speak with Philip Insel, lead author of the article entitled: Tau positron emission tomography in preclinical Alzheimer's disease The article explores the utility of tau PET imaging in three independent, large cohorts of cognitively normal individuals with high levels of amyloid (on PET imaging). We discuss specific areas of the brain with high tau concentration and how this differs from the traditional Braak model from neuropathology data. Philip also details how tau PET imaging can play a role in clinical trials.  Additionally, we welcome Dr Adam Handel onto the team as a new podcast co-host for this episode and many more to come! Check out the full article on the Brain website: https://doi.org/10.1093/brain/awac299 This episode was co-hosted, edited and produced by Xin You Tai; co-hosted by Adam Handel; co-produced by Joanne Bell and Sarosh Irani; original music by Ammar Al-Chalabi.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.12.24.521746v1?rss=1 Authors: Meneghetti, M., Gudmundsen, F., Jessen, N. S., Sui, K., Baun, C., Palner, M., Markos, C. Abstract: The combination of neuroimaging and targeted neuromodulation is a crucial tool to gain a deeper understanding of neural networks at a circuit level. Infrared neurostimulation (INS) is a promising optical modality that allows to evoke neuronal activity with high spatial resolution without need for the introduction of exogenous substances in the brain. Here, we report the use of whole-brain functional [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) imaging during INS in the dorsal striatum, performed using a multifunctional soft neural probe. We demonstrate the possibility to identify multi-circuit connection patterns in both cortical and subcortical brain regions within a single scan. By using a bolus plus infusion FDG-PET scanning protocol, we were able to observe the metabolic rate evolution in these regions during the experiments and correlate its variation with the onset of the INS stimulus. Due to the focality of INS and the large amount of viable molecular targets for PET, this novel approach to simultaneous imaging and stimulation is highly versatile. This pilot study can pave the way to further understand the brain connectivity on a global scale. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

https://psychiatry.dev/wp-content/uploads/speaker/post-11087.mp3?cb=1670008136.mp3 Playback speed: 0.8x 1x 1.3x 1.6x 2x Download: Positron Emission Tomography Assessments of Phosphodiesterase 10A in Patients With Schizophrenia – Manabu Kubota et al. Schizophrenia Bulletin. 2022. Phosphodiesterase 10A (PDE10A)Full EntryPositron Emission Tomography Assessments of Phosphodiesterase 10A in Patients With Schizophrenia –

https://psychiatry.dev/wp-content/uploads/speaker/post-10639.mp3?cb=1667410739.mp3 Playback speed: 0.8x 1x 1.3x 1.6x 2x Download: A Positron Emission Tomography Study of Dopamine Transporter Density in Patients With Bipolar Disorder With Current Mania and Those With RecentlyFull EntryA Positron Emission Tomography Study of Dopamine Transporter Density in Patients With Bipolar Disorder With Current Mania and Those With Recently Remitted Mania –

https://psychiatry.dev/wp-content/uploads/speaker/post-9473.mp3?cb=1662568964.mp3 Playback speed: 0.8x 1x 1.3x 1.6x 2x Download: Lower Availability of Mitochondrial Complex I in Anterior Cingulate Cortex in Autism: A Positron Emission Tomography Study – PubMed Yasuhiko Kato etFull EntryLower Availability of Mitochondrial Complex I in Anterior Cingulate Cortex in Autism: A Positron Emission Tomography Study – PubMed

DR. RICHARD M. FLEMING, PHD, MD, JDCardiologist, Nuclear CardiologistCertified in Positron Emission Tomography (PET)Juris Prudence Doctor of LawResearcherInventorAuthorDr. Richard M. Fleming is a Nuclear and Preventive Cardiologist, born and raised in Waterloo, Iowa, USA. He attended the University of Northern Iowa and has degrees in Physics, Biology, Psychology and Chemistry. He attended the University of Iowa College of Medicine, Creighton University and the University of Texas Health Science Center in Houston. In addition to training in Cardiology he has special Certifications in Positron Emission Tomography. He was Board Certified in Internal Medicine in 1990 and Nuclear Cardiology in 1996. He developed both the Unified Theory of Vascular Disease establishing 'Inflammation” as the cause of coronary and peripheral vascular disease and the Quadratic Blood Flow Equation for Coronary Flow Reserve in the early to mid-1990s. He has published more than 50 papers in peer review medical journals, over 50 presentations at scientific conferences throughout the U.S., Europe and Asia, has authored 8 chapters in Medical Textbooks and written 3 independent books on Health Care. He has served as Faculty and a Professor at various Universities and in 2003 received a Physician of the Year award. His current work on SPECT Cardiac imaging promotes the detection of Vulnerable Inflammatory Plaques (VIPs) through reductions in radiation dosage by using principles similar to the detection of black holes and dark matter.In 1994, Dr. Fleming presented to the American Heart Association his "theory" that cardiovascular disease was due to inflammation. What was theory in 1994 has become well known fact for decades and was highlighted in 2004, with a feature on ABC's 20/20 News.Patent # 9566037 was issued to Dr. Fleming on February 14, 2017.The Fleming Method patent (FMTVDM) covers ALL methods and devices able to measure metabolic and regional blood flow differences. This breakthrough made it possible to differentiate functionality of tissue, tissue types as well as non-tissue, and the measurement of treatment response using all isotopes, enhancing agents and devices capableHolistic Life NavigationThis podcast explores how to heal stress & trauma holistically. I am your host, Luis...Listen on: Apple Podcasts Spotify Becoming You AgainBecoming You Again is for women going through divorce who need guidance and support. Listen on: Apple Podcasts Spotify The Wellness Inspired PodcastWellness is an everyday choice many struggle to make. Your wellness journey starts today. Listen on: Apple Podcasts Spotify Fit, Healthy & Happy Podcast The Fit, Healthy and Happy Podcast is designed to help you become your best overall self.Listen on: Apple Podcasts SpotifySupport the show

This segment focuses on medical diagnoses for Alzheimer's disease, Lewy body dementia and Parkinson's. The field is rapidly changing. We now have biological markers for Alzheimer's: mis-folded proteins in the brain is the common thread for all degenerative diseases, including Parkinson's disease, Lou Gehrig's disease, and frontotemporal degeneration Pick's Disease. Being able to visualize these in PET scans (Positron Emission Tomography) lets us make a definitive diagnosis 15 years before someone begins having memory problems. Suzanne Newman talks with Dr. Michael Mega, Director of the Center for Cognitive Health in Portland, Oregon. The center helps patients maximize their cognitive function as they cope with Alzheimer's disease and disorders of thinking. Blood tests are also being developed to measure the amount of these proteins in the brain that leak out through cerebral-spinal fluid into the blood, which will identify people on the Alzheimer's trajectory. Many types of treatments are being developed to stop the mis-folding and deposition of plaque in the brain, as well as the mis-folding and deposition of tangles in the brain. The goal is that people would be able to take a blood test during their yearly physical, and if they're identified as being on the trajectory, we could then institute disease-modifying drugs to keep them from getting Alzheimer's if they haven't developed memory problems. Lewy body dementia and Parkinson's look the same in terms of the mid-folded proteins. It's where the proteins are deposited that produces different manifestations of these diseases. If these proteins are deposited on the brain stem or subcortical structures, and produce damage, those manifest as slowness in moving, tremors, as well as gait and balance difficulty. If they proteins are primarily deposited on cortical structures as well as the brain stem, that produces more cognitive issues, resulting in problem-solving difficulties, visual-spacial issues, hallucinations, as well as fluctuations in attention. If they have three of the following — a REM-behavioral sleep disturbance where you act out your dreams during your sleep, visual hallucinations while awake, fluctuations in attention or alertness, and neuroleptic sensitivity — as well as a family member who says the person cannot safely live alone, we would diagnose Lewy body dementia. That's different for Parkinson's patients, where only 50 percent will develop a thinking problem where their family says they no longer safe. Most patients don't have thinking problems in the beginning stages of the disease. So the clinical distinction is stark even though the pathology is due to the same mis-folded protein. Learn more at the Center for Cognitive Health. Visit shapetrial.com to learn about a trial for Parkinson's Disease Dementia. Visit lift-adtrial.com to learn about the LIFT-AD Alzheimer's Disease trial. You can also learn about trials taking place at the Center for Cognitive Health in Portland. Brought to you courtesy of Athira Pharma.

Positrons! So cool. Check it out. 8 min Pandemics & Pathogens Past & Present Podcastchemsmith1@gmail.comFacebookTwitter @chemsmithInstagram @timcsmith1961 Direct Link to episode

To kick off our series on papers published in October 2021, we'll look at 7 papers that rely on Positron Emission Tomography (or PET) imaging to detect amyloid and tau pathology in the brain, within the context of Alzheimer's disease! If you're interested in learning about tau and amyloid based detection, alternative PET tracers in AD research, or combining PET with different imaging modalities, make sure to tune into this episode.  Sections in this episode:  Amyloid Detection (2:35)  Tau Detection (7:40)  Amyloid + Tau (10:41)  Miscellaneous (12:34) -------------------------------------------------------------- To access the folder with all the bibliographies for 2021 so far, follow this link (it will be updated as we publish episodes and process bibliographies), or click the following link below:https://drive.google.com/drive/folders/1N1zx_itPkCDNYE1yFGZzQxDDR-NiRx3p?usp=sharingYou can also join our mailing list to receive a newsletter by filling this form. Or tweet at us: @AMiNDR_podcast  --------------------------------------------------------------Follow-up on social media for more updates!Facebook:  AMiNDR  Twitter: @AMiNDR_podcastInstagram: @AMiNDR.podcastYoutube: AMiNDR PodcastLinkedIn: AMiNDR PodcastEmail: amindrpodcast@gmail.com  -------------------------------------------------------------- Please help us by spreading the word about AMiNDR to your friends, colleagues, and networks! Another way you can help us reach more listeners who would benefit from the show is by leaving us a review on Apple Podcasts or wherever you listen to podcasts. It helps us a lot and we thank you in advance for leaving a review! Our team of volunteers works tirelessly each month to bring you every episode of AMiNDR. This episode was scripted, hosted and edited by Alexandra Pavel,  and reviewed by Naila Kuhlmann and Anusha Kamesh. The bibliography and wordcloud were created by Sarah Louadi (www.wordart.com). Big thanks to the sorting team for taking on the enormous task of sorting all of the Alzheimer's Disease papers into episodes each month. For October 2021, the sorters were Jacques Ferreira, Christy Yu, Kate Van Pelt, Eden Dubchak, Kira Tosefsky, Dana Clausen, Ellen Koch and Elyn Rowe.Also, props to our management team, which includes Sarah Louadi, Ellen Koch, Naila Kuhlmann, Elyn Rowe, Anusha Kamesh, Jacques Ferreira, and Shruti Kocchar for keeping everything running smoothly.Our music is from "Journey of a Neurotransmitter" by musician and fellow neuroscientist Anusha Kamesh; you can find the original piece and her other music on soundcloud under Anusha Kamesh or on her YouTube channel, AKMusic.   https://www.youtube.com/channel/UCMH7chrAdtCUZuGia16FR4w   -------------------------------------------------------------- If you are interested in joining the team, send us your CV by email. We are specifically looking for help with sorting abstracts by topic, abstract summaries and hosting, audio editing, creating bibliographies, and outreach/marketing. However, if you are interested in helping in other ways, don't hesitate to apply anyways.  --------------------------------------------------------------*About AMiNDR: *  Learn more about this project and the team behind it by listening to our first episode: "Welcome to AMiNDR!" 

In this episode, Dr Saad Fyyaz discusses key points from a recent case report published in EHJ – Case Reports.

Day 19 of the Dog Days of Podcasting, where other podcasters and I attempt to do an episode every day in August.  The topic this year is isotopes. Find out more at dogdaysofpodcasting.com.     Email: chemsmith1 @ gmail

Day 19 of the Dog Days of Podcasting, where other podcasters and I attempt to do an episode every day in August. The topic this year is isotopes. Find out more at dogdaysofpodcasting.com. Email: chemsmith1 @ gmail

State Representatives Andrew Beeler and Andrew Fink discuss Positron Emission Tomography and the ethical implications of the Certificate of Need system. They also flush out the reasoning for and against adding a judge in the U.P.

With Marc Dweck & Anna Barton, University of Edinburgh, Edinburgh - United Kingdom of Great Britain & Northern Ireland. Link to paper Link to editorial

Dr Zieve continues his conversation with Dr Charles Gant, an MD, naturopath and integrative physician, about the four-part-brain, letting go of pain and how mindfulness practices can reduce stress and provide benefits for all sorts of health challenges, from cancer to addiction. Dr. Charles Gant has practiced Integrative, Bomplementary/Alternative and Functional Medicine for over three decades, and teaches mindfulness-based meditation, incorporating Gestalt, Rational Emotive Behavioral Therapy, Transpersonal and other mindfulness-based psychotherapies into his medical practice. His doctoral research in the 1980s predicted that mindfulness-based therapies should evoke consistent neurophysiological changes in brain function (especially frontal lobes), which should be measurable with brain neuroimagery, and this has essentially been proven in the last decade in functional Magnetic Resonance Imaging and Positron Emission Tomography research. Dr. Gant is the Director of Integrative Medicine of the neuroimagery group, Brain Enhancement Solutions and Technologies Inc. (brainenhancement.net ), which applies quantum EEG neuroimagery to diagnose and treat brain disorders and clarify the effects of brain nutritional restoration, detoxification and neurotransmitter restoration. He is also medical director and CMO of Synaptic Connections (synapticconnections.org ), a research-focused, nonprofit neuroimagery group studying the effects of neurofeedback on brain disorders and how nutrition, detoxification and neurotransmitter balancing enhance brain function and improve outcomes for various neuropsychiatric disorders. He has written several books for general readers, including "End Your Addiction Now". Read more at charlesgantmd.com. If you cannot see the audio controls, your browser does not support the audio element

Dr Zieve talks with Dr Charles Gant, an MD, naturopath and integrative physician, about the four-part-brain, letting go of pain and how mindfulness practices can reduce stress and provide benefits for all sorts of health challenges, from cancer to addiction. Dr. Charles Gant has practiced Integrative, Complementary/Alternative and Functional Medicine for over three decades, and teaches mindfulness-based meditation, incorporating Gestalt, Rational Emotive Behavioral Therapy, Transpersonal and other mindfulness-based psychotherapies into his medical practice. His doctoral research in the 1980s predicted that mindfulness-based therapies should evoke consistent neurophysiological changes in brain function (especially frontal lobes), which should be measurable with brain neuroimagery, and this has essentially been proven in the last decade in functional Magnetic Resonance Imaging and Positron Emission Tomography research. Dr. Gant is the Director of Integrative Medicine of the neuroimagery group, Brain Enhancement Solutions and Technologies Inc. (brainenhancement.net ), which applies quantum EEG neuroimagery to diagnose and treat brain disorders and clarify the effects of brain nutritional restoration, detoxification and neurotransmitter restoration. He is also medical director and CMO of Synaptic Connections (synapticconnections.org ), a research-focused, nonprofit neuroimagery group studying the effects of neurofeedback on brain disorders and how nutrition, detoxification and neurotransmitter balancing enhance brain function and improve outcomes for various neuropsychiatric disorders. He has written several books for general readers, including "End Your Addiction Now". Read more at charlesgantmd.com. If you cannot see the audio controls, your browser does not support the audio element

1.0 Credit | Program Summary: This course will explore the implications and usage of Positron Emission Tomography. Along with Dusty York, we will discuss the patient and technologists’ role and experience with PET. What disease processes are most commonly visualized through PET imaging and how did it become an integral part of oncology care? We will […]

Commentary by Dr. Valentin Fuster

In this episode, Dr Thomas Craven discusses key points from a recent case series published in EHJ – Case Reports. For the paper discussed in this episode, please visit https://doi.org/10.1093/ehjcr/ytz209.

Total ankle arthroplasty (TAA) continues to exhibit a relatively high incidence of complications and need for revision surgery compared to knee and hip arthroplasty. One common mode of failure in TAA is talar component subsidence. This may be caused by disruption in the talar blood supply related to the operative technique. The purpose of this study was to quantify changes in talar bone perfusion and turnover before and after TAA with the INBONE II system using 18F-fluoride positron emission tomography / computed tomography (PET/CT). Our study was the first to link 18F-fluoride PET/CT with pre-post evaluation of total ankle replacements. The study quantified perfusion within the talus beneath the TAA implant supporting the hypothesis that perfusion of the talus remained intact after surgery.   To view the article click here.

MEP EP#193: Robots Have Fall DamageEpisode 200 is Coming Up! Question / Answer setup like Episode 100 Send them via Audio Format to podcast@macrofab.com Matthew Prater Started out as a radiochemist making diagnostic Positron Emission Tomography agents for 15 years Went to teach chemistry and research classes in public schools for 5 years Now teaching at the University of Advanced Technology in Tempe, AZ as a professor of robotics and embedded systems Topics What did you do as a radiochemist? Antimatter? Your roll at UAT? Research Robotics and embedded systems degree? Student Innovation Projects and Performance studio projects What are they? What is your contribution? Are they assigned or do students pick them?

Commentary by Dr. Valentin Fuster

Commentary by Dr. Valentin Fuster

Hosts: Ed Brown, Penny Dumsday, Lucas Randall, Jo Benhamu 00:00:39 Winemaking in France dates back more than 12,000 years. But new research looking at the DNA of ancient grapes has found one particular variety that's remained unchanged for over 900 years. 00:09:13 The largest crater in the solar system, the South Pole-Aitken basin, is on the far side of the moon. And astronomers have found an unexpected very dense mass there, deep below the surface. 00:19:08 Positron Emission Tomography - better known as PET scans - show levels of chemical activity in the body and are useful, for example, for detecting cancer cells. Now new modified PET scanners have been demonstrated that drastically speed the process up and reduced the amount of radiation used. This episode contains traces of a BBC News report and surprise guest on stage at Glastonbury Festival 2019.

In this episode, Dr Katie Thomas discusses key points from a recent case report published in EHJ – Case Reports. For the paper discussed in this episode, please visit https://doi.org/10.1093/ehjcr/yty165.

Welcome to the self-evaluation episode of the ASCO University weekly podcast. My name is Shadia Jalal, and I am a thoracic oncologist at Indiana University. Today, we feature a self-evaluation question on the treatment of limited-stage small-cell lung cancer. And we begin by the question. A 58-year-old man with a 40-pack-year history of cigarette smoking is found to have a spiculated 2.1-centimeter left upper lobe mass on CAT scan imaging that was performed for a suspected pneumonia. His physicians decided to immediately take him to the operating room for a wedge resection of that mass. A preliminary analysis of the pathology from the wedge resection during the operation revealed small-cell lung cancer. A completion left upper lobectomy and mediastinal lymph node dissection was performed. The final pathology confirmed a T1a small-cell lung cancer with negative margins and no lymph-node involvement. Subsequent work-up included an MRI of the brain with and without gadolinium contrast and a Positron Emission Tomography, or PET scan, both of which showed no evidence of distant metastatic disease. Molecular profiling of the tumor revealed concurrent P53 and retinoblastoma mutations, as is usually seen in small-cell lung cancer. The question is, which of the following is the most appropriate next step? A, the administration of four cycles of cisplatin and etoposide in an adjuvant fashion; B, definitive radiation to the chest with concurrent cisplatin and paclitaxel; C, four cycles of carboplatin and pemetrexed; D, definitive radiation to the chest with concurrent cyclophosphamide; E, four cycles of cyclophosphamide, doxorubicin, and vincristine. The correct answer is A, four cycles of cisplatin and etoposide in an adjuvant fashion. The role of surgery in patients with limited-stage small-cell lung cancer is really limited to a very small number of those patients that might present with a peripheral small tumor. As is known, small-cell lung cancer is usually more of a central tumor with lymph node involvement. In a patient like this with limited-stage small-cell lung cancer and node-negative disease, adjuvant chemotherapy with a platinum doublet-- cisplatin or carboplatin and etoposide-- is recommended after definitive surgery, including mediastinal lymph-node dissection. Small-cell lung cancer is a cancer known for early hematogenous spread, and therefore adjuvant chemotherapy is indicated. CAV, or cyclophosphamide, doxorubicin, and vincristine, or carboplatin with pemetrexed are not appropriate treatment options in limited-stage small-cell lung cancer. In fact, pemetrexed does not have activity in small-cell lung cancer. Concurrent chemotherapy and radiation could be recommended and considered in the presence of node-positive disease, which was not the case in this situation. And if concurrent chemotherapy and radiation is to be given, cisplatin with etoposide would be the appropriate regimen administered at the time of radiation. Thank you for listening to this weekly podcast recording, "Small-Cell Lung Cancer."

On May 10th, 2018, Ami E. Iskandrian and Paco Bravo discussed Paco’s review article entitled ‘Is there a role for cardiac positron emission tomography in hypertrophic cardiomyopathy?’. The authors of this article have provided a PowerPoint file which summarises the contents of the paper and is free for re-use at meetings and presentations: http://bit.ly/2nEuMAO The article is available at: https://rdcu.be/2Wh0 Be sure to subscribe on your mobile device - search 'JNC/ASNC Podcast'.

In this interview, naturopathic physician Carrie Decker, ND, describes some of the actions she takes with patients to help reduce the risk of developing dementia and cognitive decline. Her integrative approach includes nutritional and lifestyle assessment, assessment for common risk factors or other potential exposures, and nutritional supplementation to meet her patients' individual needs. About the Expert Carrie Decker, ND, is a certified Naturopathic Doctor, graduating with honors from the National College of Natural Medicine (now the National University of Natural Medicine) in Portland, Oregon. Decker sees patients at her office in Portland as well as remotely, with a focus on gastrointestinal disease, mood imbalances, eating disorders, autoimmune disease, and chronic fatigue. Prior to becoming a naturopathic physician, Decker was an engineer, and obtained graduate degrees in biomedical and mechanical engineering from the University of Wisconsin-Madison and University of Illinois at Urbana-Champaign respectively. Decker continues to enjoy academic research and writing and uses these skills to support integrative medicine education as a writer and contributor to various resources. Decker supports Allergy Research Group as a member of their education and product development team. About the Sponsor Founded in 1979 by molecular geneticist Stephen Levine, PhD, Allergy Research Group® is one of the very first truly hypoallergenic nutritional supplement companies. For nearly 40 years Allergy Research Group® has been a leading innovator and educator in the natural products industry. Our dedication to the latest research about cutting-edge nutritional supplements continues to this day. Our purpose is to provide customers with products they can use to improve their patients’ quality of life, through scientific based innovation, purity of ingredients, education and outstanding service. ARG is proud to be a sponsor of the Clinical Education LinkedIn Forum, a closed peer-to-peer group on LinkedIn where healthcare professionals can ask clinical questions and receive evidence-based and clinical-based responses by experts in their field. Visit www.clinicaleducation.org/linkedin for more information & to sign up for free! Visit www.allergyresearchgroup.com for more information on ARG and our products. Transcript Karolyn Gazella: Hello, I'm Karolyn Gazella, the publisher of the Natural Medicine Journal. Today we're talking about maintaining healthy brain function with naturopathic physician, Dr. Carrie Decker. Before we begin, I'd like to thank the sponsor of this podcast who is Allergy Research Group. Dr. Decker, thank you so much for joining me. Carrie Decker: Thanks Karolyn, I'm glad I'm able to be with you today. Gazella: So we're going to start by having you remind us of the medical definition of dementia, and then tell us how common these conditions are. Decker: Yeah, so dementia basically is the mental decline and associative changes in memory, mood and even personality which can occur from an acute incident, such as a vascular event or head injury, or be the progressive changes we see with conditions such as Alzheimer's and Parkinson's Disease, or even alcoholism. There are other less common causes of dementia as well. Not surprisingly, many of these conditions can overlap, particularly vascular and Alzheimer's dementia. The main difference with vasculars and Alzheimer's dementia, is that with a vascular event there will be a more sudden decline and then a fairly stable period compared to the typical slow decline of Alzheimer's disease. With a vascular event you might see a sudden change in personality, mood, language or even motor symptoms. Personality, mood and motor changes also may occur with Alzheimer's disease, but are generally in the later stages and occur gradually. Vascular or stroke related dementia accounts for 10 to 20% of dementia in the US and Europe. And the most common type of stroke is ischemic stroke which represents roughly 80% of all strokes in the US. There actually is a region in the US known as the stroke belt in the Southeast, which I was unaware of. Multiple studies have found a higher incidents of stroke in this region. Even in well characterized populations such as healthy male physicians and patients born there. There are many subcategories of ischemic stroke and, of course, all are associated with conditions such as a clot or vessel disease which leads to obstruction and reduced blood flow. And with this oxygen, the nutrients to a focal region of the brain. With a hemorrhagic stroke, which is often associated with hypertension and trauma, blood leaks into the brain and locally increases pressure in the surrounding region. Changes with a hemorrhagic stroke may occur somewhat gradually over minutes or hours, where the intracerebral hemorrhage are very suddenly with a subarachnoid hemorrhage. Clinically, the course of events helps to diagnose which type of stroke someone had, but brain and vascular imaging is required for diagnoses. Incidents of cognitive impairment in dementia after stroke ranges from six to 32% which becomes clouded with factors contributing to other types of dementia the longer the patient is followed. Alzheimer's dementia is most common type of dementia. In the age specific incidents ranges from less than 1% in an individual 65 to 70 years of age, to as high as 8% in individuals 85 years in age and older. Early onset Alzheimer and dementia can occur in individuals as young as 30, however this is far less common and usually genetically related or many misdiagnoses and other conditions which can cause cognitive changes. Gazella: Perfect. So what I'd like to do, is I'd like to focus on Alzheimer's a little bit, because it is the most common form of dementia as you mentioned. So what are some of the hallmark changes that take place in the brain, that can indicate Alzheimer's has set in? Decker: So all this again is pretty gradual, but the key things that occur in the brain with Alzheimer's dementia, which many people ... the physicians out there, at least will remember from cramming for pathology tests, are extra cellular deposits to amyloid beta peptides near fibrillary degeneration and associated tangles and neuritic plaques. These are not specifically seen with imaging, but analysis techniques and tracers are constantly being developed that can help us see these changes more specifically. Additional biomarkers that assess for changes in markers related to tau and amyloid beta in the cerebral spinal fluid are also being developed to help determine the risk of cognitive decline and assess for Alzheimer's disease, but are not yet recommended for routine diagnostic purposes. Brain imaging with an MRI is indicated in the evaluation of dementia and is capable of identifying alternative diagnoses such as the cerebral vascular types of events. Contrast may be used, excuse me, to help visualize the regions of vascular compromise or even an altered blood-brain barrier. Structural changes seen in an MRI with Alzheimer's dementia include general and focal atrophy, as well as white matter lesions; however, these findings are non-specific. The most characteristic finding with Alzheimer's disease is reduced hippocampal volume, or medial lobe atrophy, which must be evaluated relative to one's age, as a decrease in volume is normal with aging, as well. At times, there might be a dramatic reduction in hippocampal volume of over 40%. Positron Emission Tomography, which is commonly called a PET scan, with amyloid tracers can help us determine if there's an amyloid burden on the brain and this helps rule out the likelihood of Alzheimer's dementia if they're not found. But, it's not diagnostic if they are found, because you still have to rule out other types of pathology. Gazella: Okay, perfect. Now what are some of the symptoms of Alzheimer's disease? Decker: As most people ... even an untrained non-professional would know, the cognitive impairment is one of the most common signs that we see. Especially, initially, with Alzheimer's dementia. But it may be accompanied by executive disfunction and visual spatial impairments. Executive disfunction may manifest as difficulties in things like problem solving, multi-tasking, and abstract reasoning. Visual spatial impairment can manifest as changes with difficulties with reading, discriminating form and color, perceiving contrast, and detecting motion. For the most part, these deficits and changes manifest insidiously. The memory changes with Alzheimer's dementia involve significant deficits and declarative episodic memory, that is the memory of events occurring at particular time and place, which relies heavily on the hippocampal function. Memories for recent events are also impaired early in Alzheimer's disease, whereas the ability to recall something that's mentally rehearsed, like an address, is kind of spared early on. Longer term memories, which have been consolidated and in essence kind of rehearsed over years, are also spared because they don't rely on the hippocampal function. The deficits in immediate recall of rehearsed items, as well as semantic memory, the knowledge and facts we accumulate through our lives, gradually develop with time. Procedural memory, like knowing how to tie your shoes, can become affected in the later stages. Generally, the earlier changes are described overall, as recent memory impairment. Kind of avoid confusion and language that's often over a patient or caregiver's level of understanding. Also, with this we might see neuropsychiatric changes, particularly in the mid to late stages of the disease. This can include apathy or depression, irritability or related disengagement. More severe behavioral disturbances, such as aggression, wandering, and psychosis or hallucinations, also can be seen but really should be evaluated for further other possible causes, such as infection or medication-related toxicity, which is also more common in the elderly. It is not uncommon for patients to underestimate their deficits and offer alibis or explanations for them when they're pointed out, which kind of contributes to some of the mood-related symptoms, such as irritability for people. Loss of insight also occurs with time. And, interestingly, those with more insight into their condition are more depressed. While those with less insight are more likely to become agitated, experience psychotic features or perform actions like leaving the house, wandering in their pajamas. Which, if someone had the insight, they were less likely to do. Seizures may also occur in 10 to 20% of individuals in the later stations of Alzheimer's disease. The seizure type isn't so much a motor one, it's more of a focal non-motor seizure which manifests with impaired awareness, confusing amnesia spells, unexplained emotions, and experience of a metallic taste. Sleep disturbances are also common with Alzheimer's disease and may occur early in the disease process. This includes the fragmented sleep. It also may manifest as longer sleep. Sleep time generally decreases by 30 minutes per decade, starting at mid-life. So some sleep changes are also normal with aging. Poor sleep also happens to be a risk factor for cognitive decline and dementia, which is important to note. Gazella: Yeah, it's a devastating diagnosis, there's no question about it. And today we're talking about reducing risk. How do we even know that's possible? Decker: Whenever I think about risk for any type of disease, I think about, "Well, what are the risk factors?" And if we can associate it with a risk factor, if we deal with those risk factors then we're reducing your risk. So, from the Alzheimer's disease, specifically risk factors are hypertension, dyslipidemia, and altered glucose metabolism. Each, of course, is treatable. Individuals who are physically active have a reduced incidence risk of Alzheimer's disease and cognitive decline. Exercise, of course, also reduces the risk of these other things; the hypertension, dyslipidemia, and hyperglycemia. So we really can't say enough about that. Long-term use of certain medications, such as benzodiazepines, anticholinergics, antihistamines, opioids, and proton pump inhibitors, may be associated with increased risk of Alzheimer's disease. So working with patients to discontinue these, if not needed, may really benefit brain health. Exposure to environmental pollutants, including air pollution, second-hand smoke, or pesticides may put someone at increased risk for Alzheimer's disease. Chronic infections, such as Lyme disease, also may put someone at risk for developing dementia. That can be mistaken for Alzheimer's disease, but the inflammatory aspect of any type of chronic condition also may play into something that may later manifest as Alzheimer's. Cigarette smoking contributes to cardiovascular disease and hypertension, both of which are risk factors for Alzheimer's disease. The high-sugar diet, of course, contributes to the development of diabetes and hyperinsulinemia, which increases the risk of Alzheimer's. Excessive alcohol use contributes to dementia in its own right and affects memory acutely. Chronic use of alcohol in excess also contributes to hyperglycemia and the nutritional deficiencies, which may also be contributing factors to longer-term memory problems, as well as Alzheimer's. So, with so many things that are risk factors that are associated with Alzheimer's disease, correcting them inevitably reduced the risk. And then when we start to eliminate many of these factors that are known risk factors for Alzheimer's disease, or at least associated with it, the reduction in risk, of course, compounds as well. Genetically, there are definitely some things that we're unable to change, per se, but we can still influence the phenotype by addressing environment, nutritional, and other factors which impact it. Gazella: Well, that's great. And I would like to talk about nutrition and specific diet. You mentioned high-sugar diet as being a possible risk factor. When it comes to reducing risk, what do you like to emphasize and why? Decker: For me, really that's one of the biggest places to start. Reducing the high intake of high glycemic foods, like the breads, pastas, desserts and sugary snacks, often is one of the first changes that most people need to make. So often, people are grabbing these things for a quick energy fix because they're easy. And they also come with a blood sugar spike and then a blood sugar crash. Good brain food really includes foods that provide the essential vitamins and minerals, proteins, and healthy fats. Eating a diet that has lots of color, and not the artificial variety, helps people to take in the necessary vitamins and minerals, as well as many other phytonutrients found in fruits and vegetables. Nuts like walnuts, which provide healthy fats, protein, Vitamin E, as well as other nutrients and salmon, which provides a lot of Omega-3 fatty acids, are particularly good things to routinely include in the diet. A higher total intake of Omega-3 fatty acids, particularly DHA, is associated with a reduced risk of Alzheimer's disease. DHA helps reduce the amyloid beta peptide accumulation, as well as oxidative damage, which also is a contributor to Alzheimer's. One more part of that, when you dial really into the diet more, on an individual basis there might be other things that come up, things like the food sensitivities, the allergies, different types of things that cause inflammation. And for some sensitive people, even things that are high in histamine might be something to reduce. Histamine is an inflammatory mediator, which released from basophils and mast cells in the body, like when we have an allergic response, but it's also found in certain [inaudible 00:11:40] like fermented meats and wine. People can become more sensitive to foods like this when the lining of the gut is damaged, or if they have certain genetics related to the breakdown of histamine. Histamine increases the blood-brain barrier permeability, which can contribute to neuroinflammation and neurodegeneration. Gluten absolutely should be out of the diet for people with celiac disease, as it's been determined in this population, specifically, to contribute to cognitive impairment, as well as nutritional deficiencies. But, not only them, the people who are not affected by celiac disease also can have an inflammatory response and with this foggy thinking, however we don't have research that I'm aware of that specifically connects it with Alzheimer's yet. Gazella: Okay, so it sounds like a really solid anti-inflammatory diet. In addition to diet, you mentioned exercise. You mentioned sleep. But what other lifestyle factors are critical to look at when it comes to reducing risk of dementia in the patient population? Decker: Yeah, like I said, exercise is one of those things that just is important for so many aspects of metabolic health, but also has other ways that it improves cognitive function. It's something that supports the levels of brain-derived neurotrophic factor in the body. We shorten that up, calling it BDNF. And that improves neurogenesis and cognitive pathways in the brain. Exercise also has been shown to increase hippocampal and total brain volume, which we already talked about as being something that happens with Alzheimer's disease. Cognitive stimulating also benefits cognition, and that's been shown in studies. Just something people talk about. So whether this includes reading a book, playing a game of cards, or learning a new musical instrument or other skill, it's important to include. Eliminating smoking and excessive alcohol intake also should be a part of a dementia protocol. But, also general health promoting advice. Healthy sleep is important for cognitive function and preventing dementia. So working with lifestyle to make adaptations, such as new blue light or other stimulating things at least an hour before bed might come into play with people if the sleep is poor. Gazella: So Let's talk a little bit more specifically about nutritional factors and how they might contribute to cognitive decline in Alzheimer's disease. Decker: Nutritionally, deficiencies or lower levels of certain vitamins, minerals, or other essential nutrients have been shown to be associated with Alzheimer's disease. This includes the B vitamins; B-12 and folate, Zinc, Vitamin D, as well as tocophorols, and tocotrienols. Lower levels of CoQ10, which our body produces, have also been shown in some studies to be associated with an increased risk of dementia. I believe it's critically important to start with the necessary nutrients, such as these, because their impact in the body extends far beyond just the brain. Zinc has a critical function in the brain and lack of zinc can cause neuronal death. Low zinc levels are associated with a poor ability to smell and depression. So if these symptoms are also mentioned, screening should be considered. Homocysteine levels have been observed to be significantly higher in patients with Alzheimer's disease and also can be deficiencies in the B vitamins; folate, B-12, or riboflavin. Homocysteine elevation also is commonly seen in cardiovascular disease and depression. So if these are also an issue for a patient, and even if not really, this should also be considered. Vitamin D access in your [inaudible 00:14:45] hormone and also impacts genetic expression. Vitamin D levels should be at least 30 nanograms per milliliters and I would recommend even higher, really around 50 nanograms per milliliters. Low levels of vitamin D are also often seen with cardiovascular disease and should be a part of screening for that. Tocophorols, tocotrienols, and CoQ10, they're all fat-soluble, neuroprotective antioxidants and they're also cardio-protective. They support not only a healthy brain, but they reduce the risk of cholesterol oxidation and they support health vessel function, which can help reduce the risk of the vascular dementia, which we talked about earlier as well Gazella: What about other botanicals or natural substances? Are there any others that have evidence supporting cognitive function and helping reducing risk? Decker: Yeah. There's so many that I kind of got into thinking about some of them and there's way too many to discuss. But, I'm looking at ... I wanted to talk about some of them with the biggest evidence that I've seen. So because inflammation plays a role with Alzheimer's disease, we talked about that with diet. Some different therapies, which can help reduce inflammation like oxidative shots, can be helpful. But some other mechanism-like things like essential fatty acids also may improve dementia. When we talk about managing inflammation with natural substances, curcumin, the active compound found in tumeric is often at the top of the list. And it comes into play here, too. Curcumin has been shown to improve working memory, attention, and reduce cognitive decline in healthy elderly patients. Curcumin has clinical evidence it helps reduce depression, as well. Which, again, is common with Alzheimer's disease. Mechanistically, it has been shown to reduce oxidative stress and accumulation of the beta amyloid plaques, at the same time reducing our increasing levels of protective antioxidants, such as superoxide dismutase. Of course, making sure the curcumin is bioavailable is very important. The best data I've seen comparing a lot of the [inaudible 00:16:35] curcumin preparation suggests that the best bioavailable can be obtained with a molecular dispersion process that then answers the water solubility and dispersion of fat-soluble ingredients, like curcumin. With this type of preparation, it's been shown to be even six times higher absorption than the more commonly used curcumin phytosome that's found in many supplements. Another one that has a lot of evidence behind it is Huperzine A. Huperzine A is an extract from the club moss and it acts as an acytlcholinesterase inhibitor, which also happens to be one of the mechanisms of many drugs which address dementia. Huperzine A also may help reduce dementia by regulating production of beta amyloid precursor protein, protecting the cells from oxidative stress, mitochondrial disfunction, as well as damage associated with glutamate induced toxicity. Glutamate's an excitatory neurotransmitter in the brain, and when in excess, it promotes some of this neuroinflammation and neurodegeneration that we see with a lot of chronic nervous system diseases. There've been multiple randomized, placebo-controlled trials looking at the impact that Huperzine A has on both Alzheimer's disease, as well as vascular demential. It's been shown to significantly improve cognitive function in patients with mild to moderate vascular dementia and significantly improve cognition, mood, and activities of daily living scores in patients with mild to moderate Alzheimer's disease. The benefits of Huperzine A have also benefits in other populations with findings of enhanced memory and learning in adolescence and improved recovery in elderly patients from general anesthesia. Ginkgo Biloba has been studied in many clinical trials, as well as in the studying of dementia. As a botanical, we always think of it as being this go-to for supporting microcirculation, kind of in the fingertips, the toes, the eyes, the kidneys, but the brain is also a part of that. Ginkgo's protective, in part, due to its antioxidant effects and supports circulation in the small vessels by reducing platelet activation and aggregation, as well as stimulating the release of endothelium-derived relaxation factor. In double-blind, randomized, placebo-controlled studies in patients with mild cognitive impairment, Ginkgo has been shown to improve cognitive function and reduce dementia conversion rate, improving episodic memory and even improving activity challenged gait, which is something that can be an issue with people with dementia. In a double-blind, randomized, placebo-controlled study in patients with mild to moderate Alzheimer's or vascular dementia who also had the neuropsychiatric aspect of that, Ginkgo was shown to significantly improve cognition, neuropsychiatric symptoms, functional abilities, and the quality of life in patients, as well as their caregivers. In healthy populations of middle-aged and older volunteers, Ginkgo has also been observed to positively impact memory, improving recall performance, as well as speed of processing abilities. Lipids are also very important for the brain, which is not very surprising, as the brain is very fatty tissue. Brain cells are especially rich in phospholipid choline, which the body can synthesize from a substance called citicholine, also known as CDP choline. Citicholine and phospholipid choline both support the integrity and functionality of the neuronal membrane, as well as the mitochondria. Citicholine provides choline, and enhances the synthesis of acetylcholine, the neurotransmitter that plays a significant role in memory and learning. Citicholine has been studied in multiple clinical trials with populations experiencing memory-related issues ranging from mild cognitive impairment to vascular dementia and Alzheimer's disease. A Cochrane review assessed the effectively of citicholine in 14 double-blind, randomized, placebo-controlled trials in patients with cognitive impairment due to chronic cerebral disorders, which can include both the vascular and Alzheimer's disease and found that, in patients with cognitive impairment due to these disorders, that citicholine has positive effects on memory and behavior in at least short to medium term and they recommended that studies of longer duration be conducted. Significant improvements in mental performance have even been seen in patients with early-onset Alzheimer's disease treated with citicholine, as well. In a population of patients with the apolipoprotein protein, E epsilon four allele, which increase the risk of dementia, including that of the early-onset dementia as well as vascular dementia, citicholine has been shown to significantly improve cognitive performance, also improving the parameters of cerebral blood profusion in brain bioelectrical activity patterns. In patients who had their first recent ischemic stroke, citicholine was shown to improve attention, executive function, temporal orientation, cognitive status, as well as quality of life, many of which often decline in this post-stroke period. Lion's mane mushroom is another one that's worthy of mention in a discussion of dementia, as well as in the other changes that occur with aging. Lion's mane has a long history of traditional use for supporting nerve growth and we now know it induces the secretion of nerve growth factor. In recent randomized, double-blind, placebo-controlled studies, lion's mane has been shown to significantly increase cognitive function scores in patients with mild cognitive impairment, as well as reduce depression and anxiety. In animal models, lion's mane has been shown to improve spatial short-term and visual recognition memory impairments induced by amyloid beta peptide. Peripheral neuropathy is not uncommon at all in the aging population, whether it be due to diabetes, nutritional life deficiencies, or idiopathic in nature, and lion's mane can also be a benefit for this, because of the fact that it promotes nerve growth factor again. Lion's mane, like many of the medicinal mushrooms, also may have protective effects against certain forms of cancer. Gazella: I was gonna say, there's a long list here. Decker: I know. I just have to throw this last one in. French maritime pine bark extract also is another one that's been the topic of several clinical studies related to cognitive function. Although, this one hasn't been studied in the population with Alzheimer's or the decline already, it's been studied in several different healthy population ... in different clinical studies. In population ages ranging from kids to older adults, even including 60 years in age and above, it was repeatedly shown to improve cognitive function, as well as additional memory retention, mental performance, and working memory in some of the studies. And beyond cognitive function, it is also one of these that can positively impact blood pressure, cholesterol balance, blood sugar, and has positive impacts on these other diabetes-related microvasculature complications. So it's really excellent for use in individuals who also experience these other challenges. Gazella: So that is a long list. You've identified lots of choices when it comes to nutrients and botanicals. Now, are there any safety issues or contraindications associated with this long list that you've just mentioned. Decker: Yeah. Well for the nutrients, of course, some of them such as zinc and vitamin D are appropriate only if there's a deficiency. As an excess, they can cause problems. But, things like CoQ10, tocotrienols, and essential fatty acids are really very safe and are used in part to help reduce cardiovascular disease risk, as well. The side effects that some people might experience with agents that help increase blood flow to the brain, like Ginkgo, is a slight headache. And, of course, if this occurs the dosage should be diminished or supplement discontinued if it doesn't subside. Some people might find cognitive support formulas, and even things like CoQ10 and phospholipids alone, to be somewhat stimulating. Not like the jitters type of thing, life coffee, but feeling like a little supercharged. A little of this sounds positive. It can be really problematic if you're not able to do something with that energy or need to go to sleep. I've also seen people have more vivid dreams when taking something like Huperzine A, and that tends to usually be more transient. But if it's troubling and doesn't dissipate with time, an alternate supplement should be selected. I generally instruct people to start with low dose, especially if you using combinations of these nutrients, because they really can be very potent. Although some of the nutrients can be taken at night, I generally tell people to take anything that's intended to support cognitive function in the morning. Because we really want it to be something that helps us fly through the day and be as productive as we can be. But really, with all supplements, it is important to screen them with your doctor to make sure they don't have interactions with other medications you may be taking and to make sure they're something for you, individually, that is correct. Gazella: Yeah, that makes a lot of sense. And, it occurs to me that you mentioned formulas for brain health ... probably a lot of these ingredients that you mentioned are used in combination to be more effective. So there's a synergistic effect. Is that accurate? Decker: Yeah. Some things more than other. Different supplement companies put different combinations together and a lot of the companies look to the research, just like I'm talking about today, and see what might be appropriate to put together. When I work with things, I often use a B vitamin complex or other specific combinations meant to address homocysteine elevation, if that's an issue. Essential fatty acids and moderate doses of vitamin E, if not part of the diet routinely, should also be included. CoQ10, Vitamin E, and essential fatty acids - the fish oils, sometimes you can find those in combination because they're all a fatty substance. They often combine very well. Vitamin D and zinc tend to be single nutrient therapies that people are on because we use them for all sorts of things, including immune support as well as mood. So those will be things, individually, people take. Generally, if someone's healthy and not experiencing cognitive decline, that's kind of a good combination package of nutrients to just prevent the nutritional decline-related issues. But, some of the combinations ... I've seen a combination that has the lion's mane mushroom, the phospholipids, citicholine, as well as a substance called coffee fruit extract that really supports cognitive health quite well on both a short-term and long-term basis. The coffee fruit extract, which contains less than 1% caffeine, has been shown in multiple studies to increase levels of brain drive neurotrophic factor, which I kind of talked a little bit about with exercise. The brain drive neurotrophic factor promotes neurogenesis and is naturally increased in the brain when someone's working on learning something. I like the combination again, because it's so potent and it's something that someone feels the effects of in the day they take it, yet it has long-term benefits because of the fact that both lion's mane mushroom and coffee fruit extract have of promoting neurogenesis. It also contains American ginseng, and that in combination with the phospholipids, has a pretty dramatic on energy levels as well. You know, we see a decline in energy with aging populations, which also can be an issue. I've also found this combination to be really helpful with patients with depression, which makes sense. There's a common overlap with some of the things we talked about in many ways with depression. So you might want to consider it for that, as well. Gazella: Yeah, sounds like a good combination. Well this has been packed full of great information, but I'm wondering if you have any other advice for practitioners who might be listening, who are trying to help protect cognition in their patients. Decker: Yeah, and this one doesn't maybe fit in with everything I've been talking about, but I'm a naturopath and I think about things in a very whole-minded fashion ... and I live in Portland, so maybe that influences it as well, but I think it's really necessary to look at the impact of community and how being happy can really impact the overall health of our patients. Particularly in older patients, a lot of them might be alone and if they get stuck in grief ... say they have the passing of a loved one or so many people pass the more we age, and often that will be people in the family. A partner. A spouse. And that contributes to loneliness and these things don't really just eat away at the mood, but they bleed into the health in so many other ways. Community really gives people life. It gives them purpose and meaning. And being active and finding community, which someone resonates with, really serves a far greater purpose than just being an event on their schedule. And with the elderly or aging population, whether this is a local community center, a church or some other group, it can really help people find a fulfillment and happiness and that goes far beyond just that. It improves the mood and the health of the brain, as well. Gazella: Yeah, that's such an important point and I'm glad that we're ending with social support, because it has far reaching benefits. Well, once again, I would like to thank the sponsor of this topic, who is Allergy Research Group. And I'd like to thank you, Dr. Decker, for this wonderful information and joining me today. Decker: Yeah, it was great to be able to do so. Gazella: Well have a great day. Decker: Thank you, you too.

CCCF Bellani, G Measuring Inflammation - Positron Emission Tomography Podcast 102816 by OPENPediatrics

Positron Emission Tomography or PET combined with Computed Tomography or CT scan, allows for two simultaneous exams. A PET exam studies the biological activity of the inner organs. A CT exam is the study of organ anatomy and morphology. The goal is to detect abnormal organic activity such as inflammation, or tumorous or infectious lesions. This film addresses itself to those wishing to know more about the examination procedure which lasts approximately two hours.

We're analysing the matter of antimatter this week to find out what is antimatter, how is it made and why's it so rare in the Universe? We talk to researchers at CERN who are capturing anti-hydrogen so scientists can study it properly for the first time, and Dave and Meera call in to the hospital to hear how antimatter holds the key to better body scans. Diana discovers how gravity bends a beam of light and there's also news of a novel way to neutralise HIV, researchers uncover how brains gauge the passage of time, and agriculture on the microscale: scientists have found the world's smallest... Like this podcast? Please help us by supporting the Naked Scientists

We're analysing the matter of antimatter this week to find out what is antimatter, how is it made and why's it so rare in the Universe? We talk to researchers at CERN who are capturing anti-hydrogen so scientists can study it properly for the first time, and Dave and Meera call in to the hospital to hear how antimatter holds the key to better body scans. Diana discovers how gravity bends a beam of light and there's also news of a novel way to neutralise HIV, researchers uncover how brains gauge the passage of time, and agriculture on the microscale: scientists have found the world's smallest... Like this podcast? Please help us by supporting the Naked Scientists

Aims: In this study, we aimed to compare cerebrospinal fluid (CSF) levels of total tau (t-tau), phosphorylated tau (p-tau(181)) and positron emission tomography with F-18-fluorodeoxyglucose (FDG-PET) in the differential diagnosis of Alzheimer's disease (AD) under clinical conditions. Method: In a cross-sectional, blinded, single-center study, we examined a sample of 75 unselected memory clinic patients with clinical diagnoses of dementia of Alzheimer type (DAT; n = 24), amnestic mild cognitive impairment (MCI; n = 16), other dementias (n = 13) and nondemented controls (n = 22). Discriminative accuracy, sensitivity and specificity were calculated and compared using ROC analyses. Results: p-tau(181) and FDG-PET were comparable in separating DAT from controls (sensitivity: 67 vs. 79%; specificity: 91% for both) and patients with other dementias (sensitivity: 71 vs. 79%; specificity: 100% for both). The sensitivity of p-tau 181 in differentiating MCI patients from controls was significantly (p < 0.05) superior to that of FDG-PET (75 vs. 44%) at a comparably high specificity (82 vs. 91%); t-tau measures were less accurate in all analyses. Conclusions: FDG-PET and CSF p-tau(181) levels are able to discriminate DAT in heterogeneous and unselected samples with a high accuracy. CSF p-tau(181) might be somewhat superior for a sensitive detection of patients with MCI. Copyright (C) 2010 S. Karger AG, Basel

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.04.17.046300v1?rss=1 Authors: Dukart, J., Holiga, S., Rullmann, M., Lanzenberger, R., Hawkins, P. C. T., Mehta, M. A., Hesse, S., Barthel, H., Sabri, O., Jech, R., Eickhoff, S. B. Abstract: Recent studies have shown that drug-induced spatial alteration patterns in resting state functional activity as measured using magnetic resonance imaging (MRI) are associated with the distribution of specific receptor systems targeted by respective compounds. Based on this approach, we introduce a Matlab-based toolbox (JuSpace) allowing for cross-modal correlation of MRI-based measures with positron emission tomography (PET) and single photon emission computed tomography (SPECT) derived estimates covering various receptor systems including dopaminergic, serotonergic, noradrenergic, and GABAergic (gamma-aminobutric acid) neurotransmission. We apply JuSpace to two datasets covering Parkinson's disease patients (PD) on and off levodopa and risperidone-induced changes in rsfMRI and cerebral blood flow (CBF). We correlate rsfMRI derived PD- and levodopa-induced local activity alterations with PET and SPECT maps covering the above neurotransmitter systems. Similarly, we correlate the effects of risperidone on CBF with respective maps. Consistently with the predominant neurodegeneration of dopaminergic and serotonergic system in PD, we find significant spatial associations between rsfMRI activity alterations in PD on and off levodopa and dopaminergic (D2) and serotonergic systems (5-HT1b). Consistently with its mechanism of action, risperidone induced CBF alterations were correlated with key targets of serotonergic and dopaminergic systems. The JuSpace toolbox provides an easy framework for correlation of spatial alteration patterns across different neuroimaging modalities with PET derived receptor maps. Taken together, toolbox allows for cross-modal biologically meaningful evaluation and interpretation of image-derived spatial alteration patterns. Copy rights belong to original authors. Visit the link for more info