Memory Loss, Alzheimer'S Disease and Dementia: A Practical Guide For Clinicians 3Rd Edition Andrew E. Budson MD - Ebook PDF
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Memory Loss, Alzheimer’s
Disease, and Dementia
THIRD EDITION
Andrew E. Budson, MD
Neurology Service, Section of Cognitive & Behavioral Neurology, Veterans
Affairs Boston Healthcare System, Boston, MA
Alzheimer’s Disease Research Center & Department of Neurology, Boston
University School of Medicine, Boston, MA
Harvard Medical School, Boston, MA
The Boston Center for Memory, Newton, MA
Title page
Copyright
Acknowledgments
Disclosures
Saving Money
References
In the Clinic
At the Bedside
History
Review of Systems
Medical History
Allergies to Medications
Social History
Family History
Physical Examination
Laboratory Studies
Summary
References
A Three-Step Approach
Is Dementia Present?
References
Section II: Differential Diagnosis of Memory Loss and
Dementia
4. Alzheimer’s Disease
Alzheimer’s Pathology
Neurochemistry
Diagnostic Criteria
Laboratory Studies
Differential Diagnosis
Treatments
References
Laboratory Studies
Differential Diagnosis
Treatments
References
Clinical Diagnosis
Laboratory Studies
Differential Diagnosis
Treatments
References
Criteria
Laboratory Studies
Differential Diagnosis
References
Differential Diagnosis
References
Criteria
Differential Diagnosis
Treatments
References
Criteria
Laboratory Studies
Differential Diagnosis
Treatments
References
Criteria
Differential Diagnosis
Treatments
References
Terminology
Differential Diagnosis
Treatments
References
Criteria
Laboratory Studies
Differential Diagnosis
Treatments
References
Criteria
Lumbar Puncture
Other Studies
Treatments
References
Criteria
Differential Diagnosis
Treatments
References
Criteria
Clinical Presentation
Differential Diagnosis
Treatments
References
Disrupted Sleep
Hormones?
Metabolic Disorders
Diabetes
Lyme Disease
Seizures
References
18. Goals for the Treatment of Memory Loss, Alzheimer’s Disease, and
Dementia
Talking About Treatments for Alzheimer’s Disease
References
Huperzine A
References
20. Memantine
Mechanism of Action
Efficacy of Memantine
Titrating Memantine
References
Vitamin D
Vitamin E
Ginkgo Biloba
Antiinflammatories
Prevagen
References
22. Nonpharmacological Treatment of Memory Loss, Alzheimer’s
Disease, and Dementia
Helpful Habits
Power of Pictures
Magic of Music
Mediterranean-Style Diets
Aerobic Exercise
References
Disease-Modifying Treatments
References
References
References
References
27. Pharmacological Treatment of the Behavioral and Psychological
Symptoms of Dementia
References
References
29. Legal and Financial Issues in Memory Loss, Alzheimer’s Disease,
and Dementia
Legal Planning
Financial Planning
The Patient Who Does Not Want You to Talk to Their Family
References
Episodic Memory
Semantic Memory
Procedural Memory
Working Memory
Concluding Comment
Index
Any screen, Any time, Anywhere
Copyright
Elsevier
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
Notice
The term Boss has been applied to masses of intrusive rock which
form at the surface rounded, craggy or variously-shaped eminences,
having a circular, elliptical or irregular ground-plan, and descending
into the terrestrial crust with vertical or steeply-inclined sides (Fig.
28). Sometimes they can be seen to have pushed the surrounding
rocks aside. In other places they seem to occupy the place of these
rocks through which, as it were, an opening has been punched for
the reception of the intrusive material.
Occasionally, more especially in the case of large bosses, like those
in which granite so frequently appears, the eruptive mass may be
observed to rise here and there in detached knobs through the
surrounding rocks, or to enclose patches of these, in such a manner
as to indicate that the large body of eruptive material terminates
upward in a very irregular surface, of which only the more prominent
parts project through the cake of overlying rocks. In true bosses,
unlike sills or laccolites, we do not get to any bottom on which the
eruptive material rests. Laccolites, indeed, may be regarded as
intermediate between the typical sill and the typical boss. The
difference between a laccolite and a boss lies in the fact that the
body of the laccolite does not descend into an unknown depth in the
crust, but lies upon a platform on which it has accumulated, the
magma having ascended by one or more ducts, which generally bear
but a small proportion in area to the mass of the laccolite. The boss,
on the other hand, is not known to lie on any horizon, nor to
proceed from smaller ducts underneath, but plunges as a great pillar
or irregular mass, which may frequently be noticed to widen
downwards into the crust. There can be no doubt, however, that
many masses of eruptive rock, which, according to the definition
here given, should be called bosses, would be found to be truly
laccolites if their structure below ground could be ascertained. It is
obvious that our failure to find any platform on which the body of a
boss lies, may arise merely from denudation having been as yet
insufficient to lay such a platform bare. It is hardly probable that a
boss several miles in diameter should descend as a column of that
magnitude to the magma-reservoir from which its material came.
More probably it has been supplied through one or more smaller
ducts. The large boss now visible at the surface may thus be really a
laccolitic expansion on one or more horizons. M. Michel Lévy lays
stress on the general widening of granitic bosses as they descend
into the crust.[35] While his observations are supported by many
illustrations from all parts of the globe, and are probably true of the
deeper-seated masses of granite, it is no less true that numerous
examples have been met with where a granite boss is sharply
marked off from the rocks which it has invaded and on which it may
be seen to lie. Apart from the cases where granite seems to form
part of a vast internal, once molten mass, into which its encircling
gneisses seem to graduate, there are others in which this rock, as
now visible, has been injected into the crust as a boss or as a
laccolite. Instances will be described in later chapters where such
bosses have risen through Cambrian, Silurian, Devonian and
Carboniferous formations. It may be said that between such granitic
intrusions and volcanic operations no connection can be traced. But
reasons will be brought forward in later chapters to regard some of
the granitic bosses as parts of the mechanism of Palæozoic
volcanoes. It will also be shown that among the intrusive rocks of
the Tertiary volcanic series of Britain there occur bosses of truly
granophyric and granitic material. Hence, though mainly what is
called a "plutonic" rock, granite has made its appearance among the
subterranean protrusions of volcanoes.
[35]M. Michel Lévy, Bull. Carte Géol. France, No. 35, tome v. (1893),
p. 32. The view stated in the text is also that adopted by Prof.
Brögger with reference to the granite of the Christiania district. "Die
Eruptivgesteine des Kristianiagebietes."
It is no doubt true that many intrusive masses, which must be
included under the general name of bosses, have probably had no
connection whatever with volcanic action properly so called. They
are plutonic injections, that is, portions of the subterranean magma
which have been intruded into the terrestrial crust during its periods
of disturbance, and have not been accompanied with any superficial
discharges, which are essential in truly volcanic energy. It has been
proposed to draw a distinction between such deep-seated intrusions
and those which represent volcanic funnels.[36] If this were always
practicable it would certainly be desirable. But the distinction is not
one that can in every case be satisfactorily drawn. Even in regard to
granitic bosses, which may generally be assumed to be plutonic in
origin, the British examples just referred to have in all likelihood
been connected with undoubted volcanic outbursts. Without,
therefore, attempting here to separate the obviously volcanic necks
of eruptive material from the probably plutonic bosses, I propose to
describe briefly the general characters of bosses considered as a
group of intrusive rocks, together with the phenomena which
accompany them, and the conditions under which they may have
been injected.
[36] M. Michel Lévy, Bull. Carte Géol. France, No. 35, tome v. (1893).