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Mild Alzheimer’s disease – additional opinion

78-year-old male was diagnosed with possible mild Alzheimer’s disease. Medical history suggests a condition running a slow but steadily deteriorating course characterized by apathy as well as by impairment of memory, word finding difficulties and reduced vocabulary, impaired ability to make calculation and handle finances and difficulties in managing house work and going outside unsupervised. An episode with characteristics of delirium in the past is described as well. The neuropsychological evaluation describes moderate dementia.

Visual disturbances of unknown etiology

A 43 years old woman man who presented with various symptoms consisting of visual disturbances, burning sensation in the eyes, headache, hypersensitivity to noise and dizziness. Repeated neurological examinations were reported normal. A thorough neurological work-up that included blood tests, brain MRI, EEG and echocardiography was normal.
 

Post-trauma tendinopathy of left shoulder

44-year-old male that sustained a contusion to his left shoulder while falling at his home. Following the fall he suffered severe pain. An ultrasound to the shoulder was interpreted as showing some changes in the ACJ and peritendinitis of the biceps brachi. The orthopedic surgeon that examined the patient about 2 weeks post injury had the impression of tendinopathy and requested an MRI that had indicated changes in signals in the ACJ and superior impingement of the supraspinatus and peritendinitis of the biceps. On the basis of these findings an arthroscopy was suggested.

Ischemic Heart Disease

A very physically active 49-year-old male with a history of labile hypertension and hypercholesterolemia with an LDL cholesterol of 126 mg%. He underwent an exercise stress test which revealed reversible inferoseptal ischemia at a peak heart rate of 171 bpm and peak blood pressure of 195/85. In the expert's opinion, the results suggest that the patient has silent myocardial ischemia and may be at risk for sudden cardiac death, especially in light of the marked exertional level of activity.