Fatigue, mood disorders and sleep problems in patients with Parkinson's disease

De Ziekte van Parkinson (PD) is een langzaam progressieve ziekte gekarakteriseerd door zijn motorische en meer recentelijk herkende nietmotorische verschijnselen. Dit proefschrift richt zich op vermoeidheid, slaap problemen en stemmingsstoornissen, op de relaties tussen deze niet- motorische verschijnselen en hun invloed op de levenskwaliteit van Parkinsonpatiënten. Levenskwaliteit is een van de meest belangrijke maten om op een geïntegreerde manier de gevolgen van een chronische zieke te evalueren. Zie verder: Samenvatting

Supramolecular structures based on regiosisomers of cinnamyl-α-cyclodextrins - new media for capillary separation techniques

This work focuses on the preparation and application of supramolecular structures based on mono-cinnamyl-α-cyclodextrins (Cin-α-CD). Pure regioisomers of Cin-α-CD having the cinnamyl moiety at the 2-O- or at the 3-O-position, respectively, were prepared, characterized and applied in capillary electrophoresis as additives to the background electrolyte. These new monomer units with a potential to self-organize into supramolecular structures were synthesized via a straightforward one-step synthetic procedure and purified using preparative reversed-phase chromatography allowing a large scale separation of the regioisomers. The ability of the monomers to self-assemble was proved by various methods including NMR spectroscopy and dynamic light scattering (DLS). The light scattering experiments showed that the monomer units have distinguishable ability to form supramolecular structures in different solvents and the size distribution of the aggregates in water can be easily modulated using different external stimuli, such as temperature or competitive guest molecules. The obtained results indicated that the two regioisomers of Cin-α-CD formed different supramolecular assemblies highlighting the fact that the position of the cinnamyl group plays an important role in the intermolecular complex formation

The impact of the intensity of fear on patient’s delay regarding health care seeking behavior: a systematic review

This systematic review focuses on the role of the intensity of fear in patient's delay in cancer and in myocardial infarction. In a search of literature published between 1990 and June 2009, 161 articles were found. After the use of inclusion and exclusion criteria, 11 articles in cancer and 4 articles in myocardial infarction remained. High levels of fear are associated with earlier help-seeking in both diseases; for low levels of fear, the picture is unclear. The level of fear is an important factor, which should be taken into account when facilitating help-seeking by patients

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

The impact of sleep and mood disorders on quality of life in Parkinson's disease patients

Item does not contain fulltextSleep disturbances are common and often severe in patients with Parkinson's disease (PD) and their symptoms can be present at any time of day. The purpose of our study was to examine how excessive daytime sleepiness or poor nocturnal sleep quality and mood disorders influence the quality of life (QoL) in PD patients. Ninety-three PD patients from eastern Slovakia were recruited (49.5% males, mean age 68.0 +/- 9.5 years, mean disease duration 6.1 +/- 5.9 years). Sleep disturbances were measured using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI); QoL with the Parkinson's Disease Quality of Life Questionnaire (PDQ-39); depression and anxiety with the Hospital Anxiety and Depression Scale (HADS) and disease severity with the Unified Parkinson's Disease Rating Scale (UPDRS). chi (2) test, bivariate correlations and multiple linear regressions were performed. PSQI and ESS had significant correlations with worse QoL (p < 0.01, p < 0.05, respectively). HADS-D (p < 0.01), HADS-A (p < 0.01), UPDRS (p < 0.01) and disease duration (p < 0.05) were also significantly related to worse QoL. In the linear regression analysis, however, only PSQI (p < 0.01), anxiety (p < 0.001) and UPDRS (p < 0.001) remained significant. The model with PSQI explained 74% of the variance, and the model with ESS explained 63% of the variance in PDQ-39 when analyses were performed separately. In an overall model, however, only PSQI remained significant, accounting for 82% of the variance in PDQ-39. Nighttime poor sleep and anxiety are important contributors leading to a worse QoL. As these are treatable conditions, they should be recognized by clinicians and managed properly.1 december 201

Influence of Disease Severity on Fatigue in Patients with Parkinson's Disease Is Mainly Mediated by Symptoms of Depression

<p>Purpose: Fatigue is a frequent non-motor complaint of patients with Parkinson's disease (PD). Despite increasing knowledge on fatigue, the factors leading to its development are still not recognised. The aim of this investigation was to test, using structural equation modelling, the hypothesis that the influence of disease severity on fatigue is mediated by symptoms of depression in patients with PD. Method: The sample consisted of 190 PD patients (93 men, 48.9%, mean age 68.2 +/- 9.3 years, mean disease duration 6.4 +/- 4.7 years) recruited from hospitals and outpatient clinics in the East Slovakia region. The Multidimensional Fatigue Inventory, the Hospital Anxiety and Depression Scale and the Unified Parkinson's Disease Rating Scale were used. LISREL was used to analyse the data. Results: Disease severity was directly associated with symptoms of depression (beta = 0.26) and directly affected fatigue in terms of increased levels of general fatigue (beta = 0.35), physical fatigue (beta = 0.22), reduced activity (beta = 0.31) and mental fatigue (beta= 0.29), but did not directly influence reduced motivation. Symptoms of depression mediated the impact of disease severity on general fatigue (beta = 0.25), on reduced activity (beta = 0.31) and on mental fatigue (beta = 0.28), but not on physical fatigue. Reduced motivation was not mediated, but directly influenced by more symptoms of depression (beta = 0.82). Discussion: Since increased symptoms of depression mediate the impact of disease severity on three domains of fatigue in PD patients, disease management should focus on the treatment of PD and symptoms of depression. Copyright (C) 2013 S. Karger AG, Basel</p>