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Nutrition regimen in parenteral nutrition (PN) patients allows for a control of diet components. This may affect the process of lipid deposition in the vascular wall and change the risk of atherosclerosis. This study aims to examine the effect of long-term PN in adults on carotid intima-media thickness.Thirty long-term PN patients (15 men and 15 women, mean age 64.7 ± 8.5 years) and thirty healthy volunteers (HV) (15 men and 15 women, mean age 64.9 ± 8.77 years) entered the study. Total amino acid and lipid formulation intake as well as duration of PN were calculated for PN patients. The common carotid artery intima-media thickness (CCA IMT) was examined in both groups. A lower CCA IMT (right/left mean: PN - 776 ± 121 vs HV - 848 ± 121 μm, p 0.05; right/left maximum CCA IMT: PN - 935 ± 139 vs HV - 1024 ± 135 μm, p 0.05) in PN patients was observed. A lower serum level of total (PN - 131.43 ± 43.12 vs HV - 209.2 ± 48.01 mg/dl, p 0.05) and HDL (PN- 44.16 ± 12.45 vs HV - 72.57 ± 25.04 mg/dl, p 0.05) cholesterol was reported in the PN patients. A correlation between patients' age and CCA IMT was observed in the control group, but not in the PN patients (right/left mean CCA IMT - PN: r = 0.48, p-0.007 vs HV: p-0.073; right/left maximum CCA IMT - PN: r = 0.48, p-0.008, vs HV: p-0.073).Long term PN in adults is associated with lower CCA IMT. Long-term PN patients are a unique group in which carotid intima-media thickness does not correlate with the age.

Background Perfusion computed tomography (PCT) is part of acute stroke protocol in many hospitals; however, its clinical utility is still being disputed. Beyond its use in core and penumbra estimation, there is also a question about PCT role in stroke mimics diagnosis. Case series or small, retrospective studies showed equivocal results. This is the first published prospective, comparative study on PCT in differentiating stroke and seizure in acute setting. Methods Patients with acute focal neurologic deficits and without acute ischemic lesions on routine CT underwent PCT and electroencephalography (EEG) within 12 hours after symptom onset. Perfusion parameters were set up as asymmetry indices for corresponding regions of brain hemispheres. EEG findings were assigned to 1 of 5 classes. Neurologic examination was performed using the National Institutes of Health Stroke Scale (NIHSS). Follow-up noncontrast computed tomography was performed on the third day after symptom onset. If no CT changes appeared, magnetic resonance diffusion-weighted imaging was conducted. Results Final diagnosis was hemispheric ischemic stroke in 17 patients and focal neurologic deficits in the course of seizures (post- and intraictally) in 12 patients. Those groups were significantly different only in one single PCT parameter—time to peak (TTP)—in the lateral part of the middle cerebral artery territory. Analyzed groups were not significantly different in the NIHSS scores and the EEG evaluation. Conclusions TTP may stay relatively when seizure is a cause of focal neurologic deficits, but not stroke. Further, large, prospective studies are necessary to verify the results.

Gastrointestinal dysfunction is the most common non-motor symptom in Parkinson’s disease (PD) with rates rising as the disease progresses. Deep brain stimulation of subthalamic nucleus (STN DBS) improves motor functions in advanced PD. However, the effect of STN DBS on ghrelin concentration and consequently on motility disturbances as well as body weight is unclear. The objective of this study was to assess acyl-ghrelin levels in comparison to weight in advanced PD patients treated with STN DBS. Plasma concentrations of acyl-ghrelin was measured in 29 PD patients in the fasting state and at 30, 60, 120, and 180 min after a standard meal preoperatively and 3 months after surgery. The level of acyl-ghrelin in PD patients were compared with 30 age and sex-matched healthy controls. We reported that mean plasma acyl-ghrelin levels were decreased in PD patients before STN DBS in fasting (p = 0.0003) and in 30 min postprandial phase (p = 0.04) compared with healthy controls. The plasma acyl-ghrelin levels after STN DBS increased in pre-prandial and postprandial phase in PD patients at the investigated time points. Body weight gained on average 2.33 kg during the first 3 months after surgery. There was no correlation between the acyl-ghrelin plasma levels and BMI. After STN DBS in fasting and postprandial phase plasma acyl-ghrelin levels were increased. The results showed that STN DBS therapy elicited a modification of ghrelin levels, increasing its concentration in pre- and postprandial state. In addition, body weight was increased during 3 months after surgery.

WCN 2013 No: 841 Topic: 3 — Stroke Perfusion computed tomography in the diagnosis of acute focal neurological symptoms: Ischaemic stroke vs. seizures K. Kubiak-Balcerewicz, U. Fiszer, E. Naganska, C. Siemianowski, A. Sobieszek, A. Witak-Grzybowska, A. Kosinska-Szot. Witold Orlowski Independent Public Clinical Hospital inWarsaw,Warsaw, Poland; Medical Centre of Postgraduate Education, Warsaw, Poland Background: Misdiagnosing stroke may lead to unnecessary thrombolytic therapy. There are contradictory reports about the role of perfusion computed tomography (PCT) in differentiating stroke and seizures as causes of acute focal neurological symptoms. Objective: To define the role of PCT in differentiating between those two conditions in acute setting. Patients and methods: The study covered 35–85 year old patients with acute focal neurological symptoms, who underwent PCT and EEG within 12 h after symptoms onset. Presumptive ischaemic focus would be revealed in non-contrast CT in the 3rd day after symptoms onset or, when no CT changes appeared, in MRI. Neurological status was evaluated according to the National Institutes of Health Stroke Scale (NIHSS). Perfusion parameterswere set up as asymmetry indices for corresponding regions of brain hemispheres. EEG was described in a 5-stage scale. Results: Statistical analysis covered 17 patients with ischaemic stroke and 12 patients with focal neurological symptoms in the course of seizures. Those groups, taking potential effect of sex and age into account, were significantly statistically different for two parameters of PCT: MTT (mean transit time) and TTP (time to peak) in lateral middle cerebral artery territory (linear regression, p value b 0.05). TTP revealed to be the most significant parameter (logistic regression, p b 0.05). Analyzed groups were not significantly statistically different in NIHSS evaluation (T-test, p-value N 0.05) and EEG (Mann–Whitney test, p-value N 0.05). Conclusion: PCT may differentiate between ischaemic stroke and seizures as causes of acute focal neurological symptoms. Grant:No. 501-1-14-16-12—Medical Centre of Postgraduate Education. doi:10.1016/j.jns.2013.07.953 Abstract — WCN 2013 No: 2626 Topic: 3 — Stroke The association of BclI gene polymorphism and −148C/T promoter β fibrinogen with plasma fibrinogen level in acute ischemic stroke WCN 2013 No: 2626 Topic: 3 — Stroke The association of BclI gene polymorphism and −148C/T promoter β fibrinogen with plasma fibrinogen level in acute ischemic stroke A.B. Baharuddin. Neurology, Hasanuddin University, Makassar