251 research outputs found

    A systematic review and meta-analysis on the prevalence of dementia in europe. estimates from the highest-quality studies adopting the dsm iv diagnostic criteria

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    BACKGROUND: Dementia, including Alzheimer's disease (AD), is one of the most burdensome medical conditions. Usually, the reviews that aim at calculating the prevalence of dementia include estimates from studies without assessing their methodological quality. Alzheimer's Disease International (ADI) proposed a score to assess the methodological quality of population-based studies aimed at estimating the prevalence of dementia. During the last three years, the European Commission has funded three projects (Eurodem, EuroCoDe, and ALCOVE) in order to estimate the prevalence of dementia in Europe. OBJECTIVE: The aim of this study was to perform a systematic review and meta-analysis of data on the prevalence of dementia in Europe derived from studies that included only subjects with a diagnosis of dementia according to the DSM IV criteria, and that had a high quality score according to ADI criteria. METHODS: We considered the studies selected by the two projects EuroCoDe (1993-2007) and Alcove (2008-2011), and we performed a new bibliographic search. For the systematic review, we only selected the subset of articles that included subjects with a diagnosis of dementia according to the DSM IV criteria. The studies were qualitatively assessed using the ADI tool. RESULTS: The meta-analysis considered 9 studies that were carried out in Europe between 1993 and 2018 including a total of 18,263 participants, of which 2,137 were diagnosed with dementia. The prevalence rate standardized for age and sex resulted 7.1%. DISCUSSION: This is the first systematic review on the prevalence of dementia in Europe considering only high-quality studies adopting the same diagnostic criteria (i.e., DSM IV)

    Comparative effects of several cyclodextrins on the extraction of PAHs from a real contaminated soil

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    Polycyclic aromatic hydrocarbons (PAHs) are persistent organic pollutants (POPs) attracting extensive attention worldwide. Soils from many sites, such as areas of coal storage, coke oven plants, manufactured gas plants and areas of coal tar spillage present a high contamination level by PAHs. Due to their low solubility in water, the presence of PAHs in the soil matrix constitutes a long-term source of groundwater contamination, and their toxic, mutagenic and carcinogenic properties are responsible that the remediation of PAH-contaminated soil becomes a major environmental concern. In order to enhance the desorption rate of organic pollutants, various extracting agents have been used. Recently, cyclodextrins (CDs) have been proposed as an alternative agent to enhance the water solubility of hydrophobic compounds and thus their availability for biodegradation. The objectives of the present work were: to identify the level of PAHs of an aged-contaminated soil sample from a former chemical industry plant and to evaluate the ability of a natural cyclodextrin (ß-cyclodextrin, BCD) and three chemically modified cyclodextrins: 2-hydroxypropyl-ß-cyclodextrin (HPBCD), partially methylated-ß-cyclodextrin (PMBCD), and hydroxypropyl-¿-cyclodextrin (HPGCD) to extract the sixteen PAHs considered as priority pollutants by US-EPA. A real contaminated soil from the surrounding area of a deserted chemical industry situated in Asturias (North of Spain) was analyzed exhaustively in order to know its PAHs content. Then extraction experiments using Ca(NO3)2 solution or three types of different cyclodextrins solutions were carried out about the same soil. The results presented in this study show that according to Spanish legislation the analyzed soil had to be considered as contaminated soil. Its total PAHs content was about 1068.77±100.81 mg Kg-1, being phenanthrene, anthracene and naphthalene the most abundant compounds (25.3, 24.7 and 17.1 % of the total PAHs content of the soil, respectively). After the extractions experiments using CDs solutions, it was observed that the percentages of PAHs obtained were always higher than when an aqueous solution was used, although the three chemically modified cyclodextrins achieved higher extractions percentages than the natural cyclodextrin (BCD). From the sixteen selected PAHs, the highest extraction percentages was always obtained for the 3-rings PAHs, what is related with the more appropriated size and shape of this compounds with respect to the CDs cavity dimensions

    The use of new mobile and gaming technologies for the assessment and rehabilitation of people with ataxia: a systematic review and meta-analysis

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    There are no currently available disease-modifying pharmacological treatments for most of the chronic hereditary ataxias; thus, effective rehabilitative strategies are crucial to help improve symptoms and therefore the quality of life. We propose to gather all available evidence on the use of video games, exergames, and apps for tablet and smartphone for the rehabilitation, diagnosis, and assessment of people with ataxias. Relevant literature published up to June 8, 2020, was retrieved searching the databases PubMed, ISI Web of Science, and the Cochrane Database. Data were extracted using a standardized form, and their methodological quality was assessed using RoB and QUADAS-2. Six studies of 434 retrieved articles met the predefined inclusion/exclusion criteria. Two of them were diagnostic, while 4 were experimental studies. Studies included participants ranging from 9 to 28 in trials and 70 to 248 in diagnostic studies. Although we found a small number of trials and of low methodological quality, all of them reported an improvement of motor outcomes and quality of life as measured by specific scales, including the SARA, BBS, DHI, and SF-36 scores. The main reason for such low quality in trials was that most of them were small and uncontrolled, thus non-randomized and unblinded. As video games, exergames, serious games, and apps were proven to be safe, feasible, and at least as effective as traditional rehabilitation, further and more high-quality studies should be carried out on the use of these promising technologies in people with different types of ataxia

    An estimate of attributable cases of alzheimer disease and vascular dementia due to modifiable risk factors. the impact of primary prevention in europe and in italy

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    Background: Up to 53.7% of all cases of dementia are assumed to be due to Alzheimer disease (AD), while 15.8% are considered to be due to vascular dementia (VaD). In Europe, about 3 million cases of AD could be due to 7 potentially modifiable risk factors: diabetes, midlife hypertension and/or obesity, physical inactivity, depression, smoking, and low educational level. Aims: To estimate the number of VaD cases in Europe and the number of AD and VaD cases in Italy attributable to these 7 potentially modifiable risk factors. Methods: Assuming the nonindependence of the 7 risk factors, the adjusted combined population attributable risk (PAR) was estimated for AD and VaD. Results: In Europe, adjusted combined PAR was 31.4% for AD and 37.8% for VaD. The total number of attributable cases was 3,033,000 for AD and 873,000 for VaD. In Italy, assuming a 20% reduction of the prevalence of each risk factor, adjusted combined PAR decreased from 45.2 to 38.9% for AD and from 53.1 to 46.6% for VaD, implying a 6.4 and 6.5% reduction in the prevalence of AD and VaD, respectively. Conclusion: A relevant reduction of AD and VaD cases in Europe and Italy could be obtained through primary prevention

    Response of \u3cem\u3eAxonopus catarinensis\u3c/em\u3e and \u3cem\u3eArachis pintoi\u3c/em\u3e to Shade Conditions

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    In the north-east of Argentina, there are more than 100,000 hectares of silvopastoral systems where trees, forages and livestock are combined with the goal to diversify income, reduce financial risk, obtain more profit and enhance environmental benefit (Cubbage et al. 2013). The rapid adoption of this production system by farmers has generated high demand for information on shade tolerant grass and legume forage species. Axonopus catarinensis is a native grass from Itajai Vally (Brazil) that was introduced to the north-east of Argentina 10 years ago; whereas Arachis pintoi is a sub-tropical legume (also native to Brazil) adapted to acid soils and tolerant of medium levels of shade (Fisher and Cruz 1994). Visual observation of these species in the field indicated high yields and acceptable tolerance to shade. A trial was subsequently carried out with the aim to quantify dry matter yield and nutritive quality of the species under different levels of shade for silvopastoral use

    Methodological Issues in the Clinical Validation of Biomarkers for Alzheimer's Disease : The Paradigmatic Example of CSF

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    The use of biomarkers is profoundly transforming medical research and practice. Their adoption has triggered major advancements in the field of Alzheimer's disease (AD) over the past years. For instance, the analysis of the cerebrospinal fluid (CSF) and neuroimaging changes indicative of neuronal loss and amyloid deposition has led to the understanding that AD is characterized by a long preclinical phase. It is also supporting the transition towards a biology-grounded framework and definition of the disease. Nevertheless, though sufficient evidence exists about the analytical validity (i.e., accuracy, reliability, and reproducibility) of the candidate AD biomarkers, their clinical validity (i.e., how well the test measures the clinical features, and the disease or treatment outcomes) and clinical utility (i.e., if and how the test improves the patient's outcomes, confirms/changes the diagnosis, identifies at-risk individuals, influences therapeutic choices) have not been fully proven. In the present review, some of the methodological issues and challenges that should be addressed in order to better appreciate the potential benefits and limitations of AD biomarkers are discussed. The ultimate goal is to stimulate a constructive discussion aimed at filling the existing gaps and more precisely defining the directions of future research. Specifically, four main aspects of the clinical validation process are addressed and applied to the most relevant CSF biomarkers: (1) the definition of reference values; (2) the identification of reference standards for the disease of interest (i.e., AD); (3) the inclusion within the diagnostic process; and (4) the statistical process supporting the whole framework

    A systematic review of the biological processes involved in deep-brain stimulation for parkinson’s disease: A focus on the potential disease-modifying effects

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    Deep-Brain Stimulation (DBS) is an important treatment option for the management of Parkinson’s disease (PD) and is a common symptomatic treatment. However, an increasing number of studies have examined the biological processes to assess if DBS can also modify the natural history of PD by acting on its pathophysiological mechanisms. Relevant literature published up to November 2020 was systematically searched on databases such as PubMed, ISI Web of Knowledge, Academic Search Index, and Science Citation Index. The following predefined inclusion criteria were applied to the full-text versions of the selected articles: I) recruiting and monitoring of PD subjects that were previously treated with DBS and ii) investigating the electrophysiological, biochemical, epigenetic, or neuroimaging effects of DBS. Studies focusing exclusively on motor and clinical changes were excluded. Reviews, case reports, studies on animal models, and computational studies were also not considered. Out of 2,960 records screened, 43 studies met the inclusion criteria. Only three studies described a potential disease-modifying effect of DBS. However, a wide heterogeneity was observed in the investigated biomarkers, and the design and methodological issues of several studies limited their ability to find potential disease-modifying features. Specifically, 60.4% of the trials followed-up subjects for no more than 1 year from the surgical intervention, and 67.4% observed patients with PD only once after DBS. Moreover, 64.2% of the studies enrolled late-stage PD patients. Most of the studies (88.4%) reported that DBS only had a symptomatic effect, with several of them showing some limitations in the study design and recruitment of patients. Further studies using shared biomarkers are encouraged to assess if and how DBS might affect the progression of PD. Based on the existing preclinical literature, prospective clinical trials examining the course of PD in early-stage patients are needed
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