Monitoring Motor Fluctuations in Patients With Parkinson’s Disease Using Wearable Sensors

This paper presents the results of a pilot study to assess the feasibility of using accelerometer data to estimate the severity of symptoms and motor complications in patients with Parkinson’s disease. A support vector machine (SVM) classifier was implemented to estimate the severity of tremor, bradykinesia and dyskinesia from accelerometer data features. SVM-based estimates were compared with clinical scores derived via visual inspection of video recordings taken while patients performed a series of standardized motor tasks. The analysis of the video recordings was performed by clinicians trained in the use of scales for the assessment of the severity of Parkinsonian symptoms and motor complications. Results derived from the accelerometer time series were analyzed to assess the effect on the estimation of clinical scores of the duration of the window utilized to derive segments (to eventually compute data features) from the accelerometer data, the use of different SVM kernels and misclassification cost values, and the use of data features derived from different motor tasks. Results were also analyzed to assess which combinations of data features carried enough information to reliably assess the severity of symptoms andmotor complications.Combinations of data features were compared taking into consideration the computational cost associated with estimating each data feature on the nodes of a body sensor network and the effect of using such data features on the reliability of SVM-based estimates of the severity of Parkinsonian symptoms and motor complications.Engineering and Applied Science

Non-dermatophytic molds as agents of onychomycosis in Izmir, Turkey - A prospective study

9th Congress of the European-Confederation-of-Medical-Mycology/7th Trends in Invasive Fungal Infections -- SEP 28-OCT 01, 2003 -- AMSTERDAM, NETHERLANDSWOS: 000187151600031The purpose of this study was to determine the prevalence of causative non-dermatophytic filamentous fungi in onychomycosis in Izmir, Turkey, July 2001-December 2002. Totally 83 0 samples of nail scrapings from 716 patients with presumptive onychomycosis were prospectively studied, making consecutive cultures from each patient 3 times, with a-week interval in between, using conventional mycological methods. Molds were detected in 25 (12%), yeasts in 97 (47%) and dermatophytes in 84 (41%). The molds, in order of frequency, were Aspergillus niger (7), Fusarium spp. (6), Ulocladium spp. (4), Acremonium spp. (2), sterile mycelia (2), Alternaria sp. (1), Aspergillus flavus (1), Cladosporium sp. (1), and Scopulariopsis sp. (1). Careful evaluation of "molds" in onychomycosis is very important for its implications in the management of the disease.European Confederat Med Myco

A Novel Approach to Monitor Rehabilitation Outcomes in Stroke Survivors Using Wearable Technology

Quantitative assessment of motor abilities in stroke survivors can provide valuable feedback to guide clinical interventions. Numerous clinical scales were developed in the past to assess levels of impairment and functional limitation in individuals after stroke. The Functional Ability Scale is one of these clinical scales. It is a 75-point scale used to evaluate the functional ability of subjects by grading movement quality during performance of 15 motor tasks. Performance of these motor tasks requires subjects to reach for objects (e.g., a pencil on a table) and manipulate them (e.g., lift the pencil). In this paper, we show that accelerometer data recorded during performance of a subset of the motor tasks pertaining to the Functional Ability Scale can be relied upon to derive accurate estimates of the scores provided by a clinician using this scale. Accelerometer-based estimates of clinical scores were obtained by segmenting the recordings into movement components (reaching, manipulation, release/return), extracting data features, selecting features that maximized the separation among classes associated with different clinical scores, feeding these features to Random Forests to estimate scores for individual motor tasks, and using a linear equation to estimate the total Functional Ability Scale score based on the sum of the clinical scores for individual motor tasks derived from the accelerometer data. Results showed that it is possible to achieve estimates of the total Functional Ability Scale score marked by a bias of only 0.04 points of the scale and a standard deviation of only 2.43 points when using as few as three sensors to collect data during performance of only six motor tasks.Eunice Kennedy Shriver National Institute of Child Health and Human Development (U.S.)National Institutes of Health (U.S.) (grant number R21HD045873-01)Center for Integration of Medicine and Innovative Technolog

Monitoring Motor Fluctuations in Patients With Parkinson's Disease Using Wearable Sensors

This paper presents the results of a pilot study to assess the feasibility of using accelerometer data to estimate the severity of symptoms and motor complications in patients with Parkinson's disease. A support vector machine (SVM) classifier was implemented to estimate the severity of tremor, bradykinesia and dyskinesia from accelerometer data features. SVM-based estimates were compared with clinical scores derived via visual inspection of video recordings taken while patients performed a series of standardized motor tasks. The analysis of the video recordings was performed by clinicians trained in the use of scales for the assessment of the severity of Parkinsonian symptoms and motor complications. Results derived from the accelerometer time series were analyzed to assess the effect on the estimation of clinical scores of the duration of the window utilized to derive segments (to eventually compute data features) from the accelerometer data, the use of different SVM kernels and misclassification cost values, and the use of data features derived from different motor tasks. Results were also analyzed to assess which combinations of data features carried enough information to reliably assess the severity of symptoms and motor complications. Combinations of data features were compared taking into consideration the computational cost associated with estimating each data feature on the nodes of a body sensor network and the effect of using such data features on the reliability of SVM-based estimates of the severity of Parkinsonian symptoms and motor complications.Microsoft CorporationSun MicrosystemsSiemens AktiengesellschaftIntel CorporationMichael J. Fox Foundation for Parkinson's ResearchNational Science Foundation (Grant CNS-0546338)National Institute of Neurological Disorders and Stroke (U.S.) (Grant R21NS045401-02

Evaluation of patients with zygomycosis

Aim: Zygomycosis is a severe angioinvasive infection caused by Zygomycetes. We retrospectively investigated 16 cases of zygomycosis.Materials and methods: The data of patients, who had been followed between 2004 and 2010 in 8 tertiary-care teaching hospitals, were reviewed. Demographic characteristics, underlying diseases, and clinical signs and symptoms of the patients, as well as diagnostic methods, data obtained by radiological imaging methods, and the therapies, were recorded. Therapeutic approaches, antifungal agents and duration of use, and the characteristics of the cases were identified.Results: The study included 11 female and 5 male subjects. The most common symptoms and clinical signs were fever (n = 9) and retro-orbital pain (n = 7). Rhinocerebral zygomycosis was the most common form. The mean time elapsed for diagnosis was 14.26 +/- 13.96 (range: 2-52) days. Antifungal therapy was given to 15 patients (94%). In addition to antifungal therapy, 12 patients underwent surgical intervention 1 to 4 times. The mean duration of receiving antifungal therapy was 61.4 +/- 58.02 (range: 1-180) days. The median duration of treatment was 62.5 (range: 42-180) days in survivors.Conclusion: Zygomycosis is an infectious disease with high mortality despite antifungal therapy and surgical interventions

The evaluation of antifungal consumption: a point-prevalence survey

WOS: 00041171580024

Multicenter Analysis of Anidulafungin Use in Invasive Candida Infections

Introduction: Fungal infections are vital problems worldwide and their incidence have increased along with changing patient profile. Particularly candida species is still the most commonfungal agent, and the significance of non-albicans candida species have gained importance in recent years. In the present study, it was aimed to evaluate retrospectively the risk factors and distribution of candida species in patients with invasive candida infections, who were treated with anidulafungin.Materials and Methods: In the first three years (1 January 2012 to 31 December 2014) when anidulafungin came out in our country, we retrospectively evaluated the data of the patients with invasive candida infections who were treated by anidulafungin for more than 48 hours in seven university hospitals. Data were recorded to the case report forms.Results: Two hundreds and fifty-seven patients were included into the study. Fifty-six percent of the patients were male and mean age was 58.57 +/- 19.5 years. Two hundreds and three patients (79%) were hospitalized in intensive care units, 37 (14.3%) in internal medicine services, and 17 (0.07%) in surgery services. As previously described, we detected antibiotic usage in the last month (%96.9), presence of urinary catheter (90.3%) and presence of central venous catheter (82.1%) as risk factors for invasive candida infections. More than half of the patients (57.1%) with central venous catheter had candidemia. Sixty-six (47.7%) of the blood isolates were Candida albicans, 33 (23.7%) were Candida parapsilosis, 17 (12.2%) were Candida tropicalis and 13 (9.4%) were Candida glabrata. During follow up, 64.5% of 124 patients whose catheters couldn't be taken off and 47.6% of 86 patients whose catheters could be taken off died. During anidulafungin treatment, one anaphylaxis, one skin eruption and one thrombocytopenia were seen as side effects.Conclusion: In our study, we found that removal of central venous catheter of the patients with candidemia was a positive effect on mortality. We suggest that patients with candidemia, insisting on catheter removal besides antifungal treatment is necessary. We observed that anidulafungin is an effective and safe choice in invasive candida infections.C1 [Isikgoz Tasbakan, Meltem; Pullukcu, Husnu; Mermut, Gulsen] Univ Ege, Fac Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey.[Eren Kutsoylu, Oya; Alp Cavus, Sema; Avkan Oguz, Vildan; Yapar, Nur] Univ Dokuz Eylul, Fac Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey.[Sayin Kutlu, Selda; Kutlu, Murat] Univ Pamukkale, Fac Med, Dept Infect Dis & Clin Microbiol, Denizli, Turkey.[Ozturk, Barcin; Ertugrul, Mustafa Bulent] Adnan Menderes Univ, Fac Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey.[Kaya, Onur] Univ Suleyman Demirel, Fac Med, Dept Infect Dis & Clin Microbiol, Isparta, Turkey.[Turhan, Ozge] Univ Akdeniz, Fac Med, Dept Infect Dis & Clin Microbiol, Antalya, Turkey.[Senol Akat, Sebnem; Cetin, Cigdem Banu] Univ Celal Bayar, Fac Med, Dept Infect Dis & Clin Microbiol, Manisa, Turkey.[Metin, Dilek Yesim] Univ Ege, Fac Med, Dept Med Microbiol, Izmir, Turkey.[Ozhak, Betil] Univ Akdeniz, Fac Med, Dept Med Microbiol, Antalya, Turkey.[Ergin, Cagri] Univ Pamukkale, Fac Med, Dept Med Microbiol, Denizli, Turkey