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The Australian Imaging, Biomarkers and Lifestyle (AIBL) Flagship Study of Ageing is a prospective study of 1,112 individuals (211 with Alzheimer's disease (AD), 133 with mild cognitive impairment (MCI), and 768 healthy controls (HCs)). Here we report diagnostic and cognitive findings at the first (18-month) follow-up of the cohort. The first aim was to compute rates of transition from HC to MCI, and MCI to AD. The second aim was to characterize the cognitive profiles of individuals who transitioned to a more severe disease stage compared with those who did not.
Eighteen months after baseline, participants underwent comprehensive cognitive testing and diagnostic review, provided an 80 ml blood sample, and completed health and lifestyle questionnaires. A subgroup also underwent amyloid PET and MRI neuroimaging.
The diagnostic status of 89.9% of the cohorts was determined (972 were reassessed, 28 had died, and 112 did not return for reassessment). The 18-month cohort comprised 692 HCs, 82 MCI cases, 197 AD patients, and one Parkinson's disease dementia case. The transition rate from HC to MCI was 2.5%, and cognitive decline in HCs who transitioned to MCI was greatest in memory and naming domains compared to HCs who remained stable. The transition rate from MCI to AD was 30.5%.
There was a high retention rate after 18 months. Rates of transition from healthy aging to MCI, and MCI to AD, were consistent with established estimates. Follow-up of this cohort over longer periods will elucidate robust predictors of future cognitive decline.
The recent increase in terrorist bomb attacks on urban civilian targets in Europe and the USA has emphasized the need for all relevant health provision team members to become familiar with the pathophysiology and treatment of the resulting injuries. This chapter focuses on blast injuries, considers recent advances in ventilation strategies for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), and describes how this has been applied in the treatment of the severe blast injuries patient. Smoke, hot gas, or chemical inhalation injury are the most common cause of acute deterioration in lung function in burn injury patients and should always be suspected. Pulmonary contusion is a common lesion occurring in patients sustaining severe blunt chest trauma. The diagnosis of traumatic lung injury is usually made clinically with confirmation by chest radiography. Blunt thoracic trauma can result in significant morbidity in injured patients.
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