Telemedicine in Parkinson's Disease: How to Ensure Patient Needs and Continuity of Care at the Time of COVID-19 Pandemic

Introduction: With the spread of the SARS-CoV2 pandemic, telemedicine has become the safest way to guarantee care continuity, especially for chronic disabling diseases requiring frequent medical consultations and therapeutic adjustments, such as Parkinson's disease (PD). The age-related prevalence of PD, combined with increased vulnerability due to age-related comorbidities, makes PD patients protection a priority. Methodology: We reviewed potentials and limitations of teleneurology in PD and suggested a specific battery of tests, including patient-reported outcomes, smartphone applications, and neurological examination through telemedicine. Conclusions: These tools can provide full neurological consultations, with the engagement of both patients and caregivers, and can support clinicians in defining whether patients need to access diagnostic and therapeutic procedures. Telemedicine will also carry a value in the future, within conventional health care, to support clinicians in decision making, enabling more efficacious follow-up, reducing burden for caregivers, and delivering neurological expertise to local realities. These advantages are very important when there is physical distance between patients and neurologists, and when patients are not recommended to attend in-person consultations

Multiple Sclerosis And Maternity: A Psychological Explorative Qualitative Research

Considering women living with multiple sclerosis (MS), motherhood may represent a complicated event. Our aim in this study is to explore the personal meanings related to maternity and illness in women living with this disease. We have involved twenty women suffering from MS and we have administered an open interview introduced by a trigger question as a prompt aimed to elicit a narrative of their experience of illness, wishes, doubts, fears and life-projects with regard to motherhood. The interviews were audio-recorded and transcribed verbatim in order to carry out an analysis of the textual corpus. We have performed the textual analysis of the transcribed interviews through the T-LAB software. Performing a cluster analysis, four thematic clusters emerged: Daily Pain, Relationship with Health Care Services, Closing of a Circle and Family Role. We have interpreted the relationship between these themes using factorial mapping through 3 meaning vectors, representative of the following dynamics: From Concrete to Abstract; From Life-Project to Relapse; From Health Agencies to Family Support. All these meaning-vectors seem to describe the relationship between maternity and illness. Some aspects, as the presence of a stable partner or knowing diagnosis for more than ten years, might represent supporting factors for a project of motherhood. Starting from the results obtained, we provide some proposals for the definition of goals and strategies of psychological counselling within the Health Care Services

Assessment of Multiple Sclerosis Disability Progression Using a Wearable Biosensor: A Pilot Study

The evaluation of walking activity of people with multiple sclerosis (pwMS) is desirable. We evaluate the power of the correlation of motor parameters detected by the accelerometer in the Samsung Gear S2 smartwatch with multiple sclerosis (MS) disability measures and patient reported outcomes (PROs)

Ecotoxicological evaluation of caffeine and its derivatives from a simulated chlorination step

Caffeine is ubiquitous in surface and ground waters and it has been proposed as a marker of the anthropogenic pressure on the environment. Sewage treatment plants based on active sludges seem to be not very efficient in its complete removal from effluents while addnl. disinfection treatments by chlorination are able to do it. In a simulation of the chlorination step herein we report that caffeine is transformed in six byproducts: 8-???chlorocaffeine, 1,???3-???dimethyl-???5-???azabarbituric acid, N,???N'-???dimethylparabanic acid, N,???N'-???dimethyloxalamide, N-???methylurea and N,???N'-???dimethylurea. The ecotoxicity of caffeine and identified compds. was evaluated on the rotifer Brachionus calyciflorus and the alga Pseudokirchneriella subcapitata to assess acute and chronic toxicity, while SOS Chromotest and Ames Test were used to detect the genotoxic potential of the investigated compds. Moreover, we assessed the possible antigenotoxic effect of the selected compds. using SOS Chromotest after co-???incubation with the std. genotoxin, 4-???nitroquinoline 1-???oxide. Chronic exposure to these compds. caused inhibition of growth population on the rotifer while the algae seemed to be unaffected. Results indicated that caffeine (1)???, N,???N'-???dimethyloxamide (4) and N,???N'-???dimethylparabanic acid (5) reduced ??-???galactosidase activity in comparison with pos. control, both at 1 and 5 mg???/L of 4-???NQNO with a good dose-???response

A protocol for the evaluation of a wearable device for monitoring of symptoms, and cueing for the management of drooling, in people with Parkinson’s disease

Drooling is a common symptom of Parkinson’s Disease (PD) experienced in up to 70% of people with PD (PwP). Drooling can be a major problem in PwP leading to adverse physical and psychosocial issues. Current medical treatments decrease the production of saliva, whereas the problem is due to decreased swallowing frequency, not over production of saliva. Such treatments are problematic as saliva is essential for good oral health. Therefore, non-invasive treatments options such as behavioural cueing methods are recommended. A wrist-worn device delivering haptic cueing has been demonstrated to be an effective treatment method to increase swallowing frequency and a socially acceptable solution for PwP. However, the device had limited functionality and was tested on a small sample size over a short period of usage. Further work is required to understand the real-world behaviours and usage of the intervention to understand the longer-term effects with a larger sample size. This research will deploy CueBand, a discrete and comfortable wrist-worn device designed to work with a smartphone application to support the real-world evaluation of haptic cueing for the management of drooling. We will recruit 3,000 PwP to wear the device day and night for the intervention period to gain a greater understanding of the effectiveness and acceptability of the technology within real-world use. Additionally, 300 PwP who self-identity as having an issue with drooling will be recruited into an intervention study to evaluate the effectiveness of the wrist-worn CueBand to deliver haptic cueing (3-weeks) compared with smartphone cueing methods (3-weeks). PwP will use our smartphone application to self-assess their drooling frequency, severity, and duration using visual analogue scales and through the completion of daily diaries. Semi-structured interviews to gain feedback about utility of CueBand will be conducted following participants completion of the intervention

Processo de produção de grafeno e uso do mesmo

Consiglio Nazionale delle RicercheSichuan UniversityUniversidade Federal do Rio Grande do SulQuímicaDepositad

CD19 Cell Count at Baseline Predicts B Cell Repopulation at 6 and 12 Months in Multiple Sclerosis Patients Treated with Ocrelizumab

Background: The kinetics of B cell repopulation in MS patients treated with Ocrelizumab is highly variable, suggesting that a fixed dosage and time scheduling might be not optimal. We aimed to investigate whether B cell repopulation kinetics influences clinical and radiological outcomes and whether circulating immune asset at baseline affects B cell repopulation kinetics. Methods: 218 MS patients treated with Ocrelizumab were included. Every six months we collected data on clinical and magnetic resonance imaging (MRI) activity and lymphocyte subsets at baseline. According to B cell counts at six and twelve months, we identified two groups of patients, those with fast repopulation rate (FR) and those with slow repopulation rate (SR). Results: A significant reduction in clinical and radiological activity was found. One hundred fifty-five patients had complete data and received at least three treatment cycles (twelve-month follow-up). After six months, the FR patients were 41/155 (26.45%) and 10/41 (29.27%) remained non-depleted after twelve months. FR patients showed a significantly higher percentage of active MRI scan at twelve months (17.39% vs. 2.53%; p = 0,008). Furthermore, FR patients had a higher baseline B cell count compared to patients with an SR (p = 0.02 and p = 0.002, at the six- and twelve-month follow-ups, respectively). Conclusion: A considerable proportion of MS patients did not achieve a complete CD19 cell depletion and these patients had a higher baseline CD19 cell count. These findings, together with the higher MRI activity found in FR patients, suggest that the Ocrelizumab dosage could be tailored depending on CD19 cell counts at baseline in order to achieve complete disease control in all patients

The synergistic effect of an imidazolium salt and benzotriazole on the protection of bronze surfaces with chitosan-based coatings

Abstract The class of imidazolium salts contains effective anticorrosion additives for metal substrates. This study evaluated the potential of 1-carboxymethyl-3-methylimidazolium bis (trifluoromethylsulfonyl) imide (HO 2 CC 1 MImNTf 2 ) for application in cultural heritage, exploring it as anticorrosion additive in chitosan-based coatings for the protection of copper-based alloys. Under accelerated corrosion conditions with HCl vapor, the chitosan coating with HO 2 CC 1 MImNTf 2 was less effective than the one with benzotriazole. The coating with a combination of HO 2 CC 1 MImNTf 2 and benzotriazole resulted in the optimal protective efficacy of the bronze surface, and it also maintained high transparency without changing the bronze appearance

Family Functioning and Multiple Sclerosis: Study Protocol of a Multicentric Italian Project

Multiple Sclerosis (MS) is a chronic inflammatory and neurodegenerative disease, which not only affects physical functioning, but is also associated with cognitive impairments and great psychological distress. The combination of those symptoms may have negative consequences on the family functioning of patients with MS, with detrimental effects on both marital relationships and parental bonding. Furthermore, the presence of individual characteristics and of an adequate social support may also contribute to the quality and endurance of family relationships. Particularly, high levels of alexithymia, a personality trait that affects the recognition of a person's own emotions, have been associated with reduced interpersonal communication skills and enhanced anxiety/depressive symptoms. Therefore, the main aim of the present study is to provide an in-depth evaluation of family functioning and related factors in patients with MS and their families. In order to reach this goal, the perceived quality of family functioning, dyadic relationships, and parental bonding will be first investigated. Secondly, the possible associations between the quality of family relationships and the presence of alexithymia, psychological distress, and perceived social support will be examined. Patients with MS and their families who will consent to take part in the study will be asked to provide sociodemographic and clinical information, and to complete a series of questionnaires, presented and uploaded on an online dedicated platform. The final sample will be made up of 300 families, consecutively recruited from the Italian medical centers involved in the project. The results of the present study will shed light on the family functioning of patients with MS, through a comprehensive assessment of the main factors that are associated with family dynamics. A holistic evaluation of those aspects can help clinicians and researchers understand family dynamics in MS population better