The Italian tremor Network (TITAN): rationale, design and preliminary findings.

INTRODUCTION: The recently released classification has revised the nosology of tremor, defining essential tremor (ET) as a syndrome and fueling an enlightened debate about some newly conceptualized entities such as ET-plus. As a result, precise information of demographics, clinical features, and about the natural history of these conditions are lacking. METHODS: The ITAlian tremor Network (TITAN) is a multicenter data collection platform, the aim of which is to prospectively assess, according to a standardized protocol, the phenomenology and natural history of tremor syndromes. RESULTS: In the first year of activity, 679 patients have been recruited. The frequency of tremor syndromes varied from 32% of ET and 41% of ET-plus to less than 3% of rare forms, including focal tremors (2.30%), task-specific tremors (1.38%), isolated rest tremor (0.61%), and orthostatic tremor (0.61%). Patients with ET-plus were older and had a higher age at onset than ET, but a shorter disease duration, which might suggest that ET-plus is not a disease stage of ET. Familial aggregation of tremor and movement disorders was present in up to 60% of ET cases and in about 40% of patients with tremor combined with dystonia. The body site of tremor onset was different between tremor syndromes, with head tremor being most commonly, but not uniquely, associated with dystonia. CONCLUSIONS: The TITAN study is anticipated to provide clinically relevant prospective information about the clinical correlates of different tremor syndromes and their specific outcomes and might serve as a basis for future etiological, pathophysiological, and therapeutic research

[\ub9\ub2\ub3I]FP-CIT SPECT (DaTSCAN) may be a useful tool to differentiate between Parkinson's disease and vascular or drug-induced parkinsonisms: a meta-analysis.

BACKGROUND AND PURPOSE: Differentiating idiopathic Parkinson's disease from secondary parkinsonian syndromes is crucial since their management and prognosis differ considerably. Functional imaging of the dopaminergic pathway by means of [\ub9\ub2\ub3I]FP-CIT SPECT (DaTSCAN) might be useful in this regard, but its role is still controversial. The accuracy of DaTSCAN in the differential diagnosis between Parkinson's disease and vascular or drug-induced parkinsonism was therefore systematically reviewed. METHODS: MEDLINE and CENTRAL were searched for studies aiming to determine accuracy measures (sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratios) of DaTSCAN in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism. RESULTS: Five studies were included. Pooled accuracy measures in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism were relatively high, with sensitivity and specificity values above 85% and 80%, respectively. CONCLUSIONS: DaTSCAN might accurately differentiate between early Parkinson's disease and secondary parkinsonian conditions, namely vascular or drug-induced, in patients with clinically unclear parkinsonism. However, all the studies reviewed here show several methodological limits, which prevent definitive conclusions on the role of DaTSCAN being drawn in this context. Further studies are needed to confirm our results and definitely evaluate the utility of DaTSCAN in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism

Compatibilidad entre nueve cepas de Biomphalaria glabrata de áreas endémicas y no endémicas y una cepa de Schistosoma mansoni venezolanas

Se infectaron experimentalmente 9 lotes de 32 caracoles B. glabrata (de 5 a 7mm de diámetro) con miracidios de la cepa C5 de Schistosoma mansoni a razón de 5 miracidios por caracol, pertenecientes a las siguientes cepas: En el área endémica de transmisión de Esquistosomiasis mansoni a) Sector Puerta Negra, Lago Valencia, b) Cagua c) Ingenio Bolívar (Estado Aragua) d) Mariara e) Caserío El 25 f) Güigüe (Estado Carabobo). Fuera del área endémica de transmisión g) Anzoátegui (Estado Lara), h) Chabasquén (Estado Portuguesa), i) Sector La Elvira, Caripe (Estado Monagas). El período prepatente intramolusco, osciló entre 23 y 25 días, para las 9 cepas evaluadas. La duración total de la infección fue muy variable desde 20 días para la cepa Chabasquén, hasta 93 días para la de Güigüe.La producción total promedio de cercarias al tercer día de iniciada la emisión varió desde X = 74,4 para la cepa de Mariara, hasta X = 591,7 para la cepa de Chabasquén. Se evidenció la existencia de diferencias estadísticamente significativas (H = 97,4, P < 0,05) en la producción total de cercarias al tercer día de iniciada la emisión, detectándose diferencias estadísticamente significativas para casi todas las 36 combinaciones, excepto para las cuatro siguientes: Mariara/Ingenio Bolívar, Cagua/Caserío El 25, Lago de Valencia/Güigüe y Güigüe/Caripe.En lo que respecta al porcentaje de caracoles que presentaron cura espontánea, los valores mas elevados se obtuvieron en las cepas del Lago de Valencia (88,8%), Cagua (85,2%), Chabasquén (82,6%), Caripe (82,6%) y Anzoátegui (80%). Mientras que el porcentaje mas bajo se obtuvo para la cepa de Güigüe (21,4%)

[¹²³I]FP-CIT SPECT (DaTSCAN) may be a useful tool to differentiate between Parkinson's disease and vascular or drug-induced parkinsonisms: a meta-analysis.

BACKGROUND AND PURPOSE: Differentiating idiopathic Parkinson's disease from secondary parkinsonian syndromes is crucial since their management and prognosis differ considerably. Functional imaging of the dopaminergic pathway by means of [¹²³I]FP-CIT SPECT (DaTSCAN) might be useful in this regard, but its role is still controversial. The accuracy of DaTSCAN in the differential diagnosis between Parkinson's disease and vascular or drug-induced parkinsonism was therefore systematically reviewed. METHODS: MEDLINE and CENTRAL were searched for studies aiming to determine accuracy measures (sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratios) of DaTSCAN in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism. RESULTS: Five studies were included. Pooled accuracy measures in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism were relatively high, with sensitivity and specificity values above 85% and 80%, respectively. CONCLUSIONS: DaTSCAN might accurately differentiate between early Parkinson's disease and secondary parkinsonian conditions, namely vascular or drug-induced, in patients with clinically unclear parkinsonism. However, all the studies reviewed here show several methodological limits, which prevent definitive conclusions on the role of DaTSCAN being drawn in this context. Further studies are needed to confirm our results and definitely evaluate the utility of DaTSCAN in differentiating between Parkinson's disease and vascular or drug-induced parkinsonism

Primer hallazgo en Venezuela de huevos de Schistosoma mansoni y de otros helmintos de interés en salud pública, presentes en heces y secreción mucosa del molusco terrestre Achatina fulica (Bowdich, 1822)

In order to determine the presence of parasites in faeces as well as in mucous secretion of Achatina fulica snails (452) snails were collected. Twelve (12) groups from Aragua state and 2 from Portuguesa state were conformed. Of 253 evaluated snails corresponding to El Limón sector, Mario Briceño Iragorry municipality, Maracay, Aragua state, 8,70% turned out positive to eggs of Schistosoma mansoni , 2,77% Trichuris spp. and 5,93% Hymenolepis spp., when analyzing the faeces samples. Whereas for the 90 A. fulica snails from La Pedrera sector, Girardot municipality, Aragua state, in 10,42% was evidenced the presence of Strongyloides spp. larvae in faeces and in 9,52% of the same, when evaluating mucous secretion. The mucous secretion parasitological evaluation performed on every A. fulica snails groups, from Aragua state as well as from Portuguesa state, did not evidenced the presence of Angiostrongylus spp. infecting larvae. However, it was confirmed the viability of S. mansoni eggs, which demonstrated the maintenance of the biological cycle of the parasite. Based on the obtained results it is concluded that A. fulica it is a species of medical importance in Venezuela, due to it’s value as a mechanic transporter of different helminths species and as an indicator for parasitic infections within the human population.Con el propósito de determinar la presencia de parásitos en heces y la secreción mucosa de 253 caracoles correspondientes al Sector El Limón, municipio Mario Briceño Iragorry, Maracay, estado Aragua. Fueron colectados (452) ejemplares de Achatina fulica quienes conformaron 12 grupos pertenecientes al estado Aragua y 2 al estado Portuguesa. Al analizar las muestras de heces resultaron positivos a huevos de Schistosoma mansoni el 8,70%, Trichuris spp. 2,77% y Hymenolepis spp. 5,93%,. Mientras que de los 90 caracoles A. fulica, procedentes del Sector La Pedrera, del municipio Girardot, Maracay, estado Aragua, en 10,42% se evidenció la presencia de larvas de Strongyloides spp. en heces y en 9,52% de los mismos, al evaluar la secreción mucosa. En la evaluación parasitológica de la secreción mucosa realizado a todos los grupos de caracoles A. fulica, tanto del estado Aragua como de Portuguesa, no se evidenció la presencia de larvas infectantes de Angiostronylus spp. Por otra parte, se constató la viabilidad de los huevos de S. mansoni, lo cual permitió demostrar el mantenimiento del ciclo biológico del parásito. Basados en los resultados obtenidos se concluye que A. fulica es una especie de importancia médica en Venezuela, por su valor como transportador mecánico de diferentes especies de helmintos y un indicador de las infecciones parasitarias en la población humana

Cognitive onset in multiple sclerosis

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