A Systematic Review of Randomized Controlled Interventions for Parents' Distress in Pediatric Leukemia

Objective. This review aims to summarize the existing evidence concerning interventions towards reducing stress in parents with a child with leukemia and their effect in child and family wellbeing. Methods. A systematic review strategy was conducted using MEDLINE covering the period January 1980 to June 2010. Results. Seven randomized controlled trials met the inclusion criteria including in total 1045 parents participants. A variety of cognitive-behavioral interventions problem-solving skills training programs have been used for managing distress in parents and children. Outcome measures are assessed by self-report, observer report, behavioral/psychological, and physiological measures. The most prominent methodological problems were the marked heterogeneity in stress measurement and the relative absence of proper measurement and adjustment of moderating and mediating factors. The largest effect has been obtained by combined cognitive-behavioral interventions with promising but limited evidence for several other psychological interventions. Conclusions. Recommendations for future RCTs are provided, and particular attention to the quality of trial design and reporting is highlighted

The impact of automated hippocampal volumetry on diagnostic confidence in patients with suspected Alzheimer's disease: an EADC study

INTRODUCTION: Hippocampal volume is a core biomarker of Alzheimer's disease (AD). However, its contribution over the standard diagnostic workup is unclear. METHODS: Three hundred fifty-six patients, under clinical evaluation for cognitive impairment, with suspected AD and Mini–Mental State Examination ≥20, were recruited across 17 European memory clinics. After the traditional diagnostic workup, diagnostic confidence of AD pathology (DCAD) was estimated by the physicians in charge. The latter were provided with the results of automated hippocampal volumetry in standardized format and DCAD was reassessed. RESULTS: An increment of one interquartile range in hippocampal volume was associated with a mean change of DCAD of −8.0% (95% credible interval: [−11.5, −5.0]). Automated hippocampal volumetry showed a statistically significant impact on DCAD beyond the contributions of neuropsychology, 18F-fluorodeoxyglucose positron emission tomography/single-photon emission computed tomography, and cerebrospinal fluid markers (−8.5, CrI: [−11.5, −5.6]; −14.1, CrI: [−19.3, −8.8]; −10.6, CrI: [−14.6, −6.1], respectively). DISCUSSION: There is a measurable effect of hippocampal volume on DCAD even when used on top of the traditional diagnostic workup

New markers in Parkinson's disease

Parkinson's disease (PD) is a chronic, debilitating neurodegenerative disorder characterized clinically by a variety of progressive motor and nonmotor symptoms. Currently, there is a dearth of diagnostic tools available to predict, diagnose or mitigate disease risk or progression, leading to a challenging dilemma within the healthcare management system. The search for a reliable biomarker for PD that reflects underlying pathology is a high priority in PD research. Currently, there is no reliable single biomarker predictive of risk for motor and cognitive decline, and there have been few longitudinal studies of temporal progression. A combination of multiple biomarkers might facilitate earlier diagnosis and more accurate prognosis in PD. In this review, we focus on the recent developments of serial biomarkers for PD from a variety of clinical, biochemical, genetic and neuroimaging perspectives. © 2020 Elsevier Inc

MicroRNA as Candidate Biomarkers in Atypical Parkinsonian Syndromes: Systematic Literature Review

Background and Objectives: Multiple system atrophy (MSA) and progressive supranu-clear palsy (PSP) are rare atypical parkinsonian syndromes, characterized by motor and cognitive symptoms. Their clinical diagnosis is challenging because there are no established biomarkers. Dysregulation of microRNAs (miRNAs/miRs) has been reported to serve an important role in neu-rodegenerative diseases. However, the miRNA profiles of MSA and PSP patients are rarely reported. The aim of this study was to critically review the role of miRNAs as diagnostic biomarkers to differentiate these atypical parkinsonian disorders and their role in disease pathogenesis. Materials and Methods: A systematic literature search of PubMed was conducted up to February 2022 according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 15 studies were analyzed. Three studies have shown that miR-9-3p, miR-19a, miR-19b, and miR-24 are potential biomarkers for MSA. In two studies, miR-132 was downregulated, whereas miR-147a and miR-518e were upregulated in the brain tissue of PSP patients. Conclusions: The potential of miRNA is still uncertain as a potential differential diagnostic marker to identify these disorders. Pre-analytical and analytical factors of included studies were important limitations to justify the introduction of miRNAs into clinical practice. © 2022 by the author. Licensee MDPI, Basel, Switzerland

Empty-nest-related psychosocial stress: Conceptual issues, future directions in economic crisis

Τhe empty-nest syndrome is a transitional stage, when middle-aged parents are in the process of encouraging their children to take up their obligations as adults. The empty-nest syndrome is a psychological condition that affects both parents, who experience feelings of grief, loss, fear, inability, difficulty in adjusting roles, and change of parental relationships, when children leave the parental home. Τhis syndrome has gained special interest in a world where the current economic crisis has not only deepened global poverty but also a crisis of values reflected in the dynamic model of the family. The purpose of this review was to appraise the impact of psychosocial stress of the empty- nest syndrome on the parents' well-being through the years, during the current socio-economic crisis, taking into account gender, national and cultural background, socio-demographic and other context factors. We addressed the phenomenon of the "Boomerang Kids" and crowded nests as a result of current financial instability. Finally, we focused on the strategies which the family can employ to retain their resilience, according to the Transactional Model of Stress and Coping Family resilience framework and self-efficacy models. A literature review was conducted using web-based search engines provided by Medline, Scopus, Embase, Cochrane and PsychINFO. The term "empty nest syndrome'' was combined with women, men, economic crisis, parenthood, stress, menopause, midlife crisis, Boomerang kids, crowded nets, resilience, self-efficacy, wellbeing, and cultural differences. Women and men from diverse cultural groups have a different experience of the empty nest, as well as ways of coping. Distress caused by empty nest results in the incidence of symptoms of depression, behavioral symptoms and cognitive impairment. In most of studies, low marital quality and lack of social support affected negatively on a parent's well-being particularly for those experiencing the return of their "Boomerang kids". However, the financial crisis can transform an empty-nest into a "dynamic nest" by community health promotion services. Social support programs should be designed to strengthen family resource and improve family well-being