Multiple system atrophy is distinguished from idiopathic Parkinson's disease bythe arginine growth hormone stimulation test

Objective: Multiple system atrophy (MSA) may be difficult to distinguish from idiopathic Parkinson’s disease (PD). Our aim was to evaluate the accuracy of the arginine growth hormone (GH) stimulation test in distinguishing between MSA and PD in large populations of patients. Methods: We measured the GH response to arginine in 69 MSA (43 MSAp [parkinsonism as the main motor feature] and 26 MSAc [cerebellar features predominated]) patients, 35 PD patients, and 90 healthy control subjects. We used receiver-operating curve analysis to establish the arginine cutoff value that best differentiated between MSA and PD. Results: The GH response to arginine was significantly lower (p 0.01) in MSA than in either PD patients or control subjects. At a cutoff level of 4g/L, arginine distinguished MSAp from PD with a sensitivity and specificity of 91% and MSAc from PD with a sensitivity of 96% and specificity of 91%. The arginine test had a positive predictive value for MSA of 95%. The GH response to arginine was not affected by disease duration or severity, MSA motor subtype, pyramidal signs, response to dopaminergic therapy, or magnetic resonance imaging findings. Interpretation: The GH response to arginine differentiates MSA from PD with a high diagnostic accuracy. The results suggest an impairment of cholinergic central systems modulating GH release in MSA

An Experience in IPv6 Networking supporting Ecumene Web Information System for Cultural Heritage

People interested in Cultural Heritage constitute a community of users characterized by a high degree of mobility. Users visiting cultural sites hosted by local institutions expect to access information pertaining to cultural/artistic heritage from anywhere at anytime, as they can through the desk at their own homes or offices. The Ecumene Web Information System, developed in the groundwork of the Ecumene Project, offers a framework for accessing the artistic and cultural information through a Web application. In this paper, we expose the underlying communication network architecture, based on the IPv6 protocol and investigate the benefits of its adoption, in terms of mobility and security support. Indeed, the need of granting different access rights to different user classes enforces the security requirements of the system. Lastly, the open issues related to the practical integration of an experimental testbed with Mobile IPv6 and IPSec support are detailed and possible solutions are presented

MIPSD (Mobility-oriented IPSec Daemon): a Tool for Integrated Mobility and Security Support in the Ecumene Network

The IP protocol is stateless and connectionless, hence cannot guarantee a secure delivery of the information. IPSec offers stateful security introducing logical connections between couples of peers. The management of these IPSec Security Associations is often delegated to dynamic protocols, such as ISAKMP and IKE, because of the obvious scalability problem of a manual configuration approach. However, the address of each peer must be known in advance to the other one in order for the ISAKMP exchange to be completed successfully. This assumption cannot be always guaranteed, especially when mobility is taken into consideration. In such cases, a proper mechanism to retrieve the correspondent peer IPv6 address must be taken into account. The demo consists of an overview of the functionalities of the Ecumene Web Information System, developed in the groundwork of the Ecumene Project, focusing mainly on the enhancements developed (in the form of the MIPSD daemon) to allow automatic IPSec SA insaturation between hosts which wants to access the network and the appropriate Site Gateway

Concomitant development of hypersexuality and delusional jealousy in patients with Parkinson's disease: A case series.

BACKGROUND: Both impulse-control disorders and delusional jealousy (DJ) may be considered non-motor side-effects of dopamine agonist therapy in Parkinson's disease (PD). We aimed to investigate the possible concomitant development of these features in PD and their clinical correlates. METHODS: We performed a cross-sectional investigation in 1063 consecutive PD patients with the Questionnaire for Impulsive Compulsive Disorders in Parkinson's disease and the Parkinson's Psychosis Questionnaire. RESULTS: 81 patients presented ICDs (prevalence 7.61%) and 23 patients presented DJ (17 males, 6 females; prevalence 2.16%). 9 male PD patients presented both DJ and ICDs (39.13% of patients with DJ, 11.11% of patients with ICDs; prevalence of 0.84% in the whole PD sample), with a concomitant onset of delusional jealousy and hypersexuality in 8 cases and a concomitant onset of delusional jealousy and pathological gambling in 2 cases. DISCUSSION: Hypersexuality and delusional jealousy may occur independently in PD patients "on" dopamine agonist therapy, but may develop together probably reflecting a common alteration of sexuality (sexual arousal and jealousy) The presence of both of these clinical features and sexuality more in general should be investigated when features of either one of them appear. Further confirmation is needed in larger samples of patients