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

Stress management for headaches in children and adolescents: A review and practical recommendations for health promotion programs and well-being

Stress is considered to be the most common factor reported to trigger headaches in children and adolescents. Although tension-type headache and migraine are the two most common types of headache in children and adolescents, they are often untreated, ignoring their stressful background. We provide a narrative review of the available evidence for health-care professionals involved in stress-related headache management and health promotion programs. An integrative plan is delivered through lifestyle improvement and biopsychosocial modifying stress response techniques. Healthy dietary choices, sleep hygiene, and regular exercise, although limited, are effective for young sufferers. Biopsychosocial therapies such as relaxation, biofeedback, hypnosis, yoga, cognitive behavioral therapy, and acupuncture focus at stress physiological and behavioral relief. Our purpose is to suggest a stress-related headache management to empower children to make healthy choices in order to improve their lifelong well-being and quality of life. We aim to authorize relationship between nurses and other health-care providers with background knowledge around stress management for pediatric headache populations. © 2017, © The Author(s) 2017

Levodopa-induced skin disorders in patients with Parkinson disease: a systematic literature review approach

The use of levodopa for treatment of Parkinson’s disease is a well-established clinical practice. Data about the true incidence and severity of cutaneous complications associated with the use of levodopa are largely lacking. Aim of this review was to evaluate the quality of evidence referring to the skin disorders caused by levodopa treatment for Parkinson’s disease. Thirty of 1084 studies were included; 8 randomized controlled trials and 22 case reports in a total of 2749 patients. Malignant melanoma was the most frequent oral levodopa-related skin disorder followed by allergic cutaneous reactions, alopecia, vitiligo, skin hyperpigmentation, Laugier–Hunziker syndrome, Henoch–Schönlein syndrome, pseudobullous morphea and scleroderma-like illness. Naranjo scores ranged from 2 to 8. Regarding levodopa clinical trials, the most frequent skin complication was peripheral edema, followed by malignant melanoma. Although evidence is not robust, melanoma is the most frequent and possible fatal levodopa-associated skin disorder, while other skin allergic or immunological reactions are less common and reversible. Although levodopa treatment may induce melanogenesis and promote melanomagenesis, existing evidence does not support an association between levodopa therapy and induction or progression of malignant melanoma. The suggested association with melanoma may reflect the well-documented association of Parkinson’s disease with melanoma rather than the exposure to the drug. Nevertheless, until a solid conclusion can be drawn, the use of levodopa in the context of malignant melanoma should be considered with caution. Well-designed prospective studies are needed to determine the cause and effect relationship between levodopa and skin disorders. © 2019, Belgian Neurological Society