UNDERSTANDING DYSPEPSIA IN PATIENTS WITH PARKINSON’S DISEASE

Objectives: Better understanding dyspepsia in Parkinson’s disease (PD) in order to improve patients quality of life.Methods: 27 patients (17 men,10 women, mean age=68,11± 12,62 years) diagnosed with PD (Hoehn-Yars scale), treated with levodopa or dopamine agonists, with gastrointestinal autonomic disorders and disturbances of gastric motility assessed by ultrasound approach undertook a trial consisting of a treatment with Trimebutine 300 mg/day for 3 months. We have assessed digestive severity symptoms scores before and after therapy: no symptoms=0, mild=1, medium=2, severe=3, comparing also to gastric motility curves.Results: Before therapy 15 patients showed delayed of the gastric emptying (55,56%), 7 normal motility (25,92%) and 5 patients rapid emptying (18,51%).Symptoms severity scores before therapy were: 8 patients (29,52%) mild ,14 patients (51,85%) medium and 5 patients (18,51%).severe. Mean dyspepsia severity index in patients with gastric motility disorders before therapy was 2,20±0,52.After therapy the same index decreased to 1,50±0,69(p=0,0009).Gastric motility curves showed an improving after therapy more important in those with delaying emptying varying with 23,45%±14,03 versus 15%±5,87% in patients with rapid emptying (either p<0,001).Conclusions An important range of patients with PD, with nausea and vomiting presented gastric motility disorders (74,07%), most of them having delay of the emptying and a satisfactory response to the treatment with Trimebutine with improving of symptom severity index and also gastric motility

Неврологические заболевания, связанные с метеорологическими факторами в условиях сильной бури: тематическое исследование у госпитализированных пациентов

Universitatea de Medicină și Farmacie Victor Babeș, Timișoara, România, Spitalul Județean Clinic de Urgență Pius Brînzeu, Timișoara, România, Congresul al VIII-lea al specialiștilor din domeniul sănătății publice și managementului sanitar 24-25 octombrie 2019 Chișinău, Republica MoldovaÎn studiul efectuat ne-am propus să investigăm afecțiunile neurologice la pacienții internați în secția de neurologie (I și II) a Spitalului Județean Timișoara, în relație cu factorii meteorologici (temperatură, umiditate, viteza vântului și presiune), în contextul unei furtuni violente care a avut loc în zona de vest a României la 17 septembrie 2017. Studiul de caz cu utilizarea unei anchete retrospective de șapte zile (15–21.09.2017) a fost realizat pe un eșantion format din 43 de pacienți (54,5% femei și 45,5% bărbați) internați în secția de neurologie (I și II), cu obținerea următoarelor rezultate la pacienți: 34,8% – internați la 19.09.2017, 26,8% – vârsta 60-70 de ani, 34,9% – accidente vasculare cerebrale (AVC), 24,5% – dei cit motor, 33,5% – TA = 140-160 mmHg, 33,5% – frecvența cardiacă = 80-100 bătăi/minut. Temperatura medie a aerului – 21,20C, umiditatea relativă – 66%, presiunea medie – 735,5 mmHg, viteza vântului la rafală – 106,9 km/h s-au înregistrat la 17.09.2017. Doar o asociere slabă s-a înregistrat în relația AVC – sex (testul Fisher exact = 0,043) și în relația frecvența cardiacă – viteza vântului la rafală (r=0,377, sig. 0,03). În concluzie, nu s-a constatat o relație semnii cativă statistic între afecțiunile neurologice și factorii meteorologici. In the performed study we aimed to investigate neurological diseases in patients admitted into the Neurology Section (I and II), of the County Hospital Timisoara, related to meteorological factors (temperature, humidity, wind velocity and pressure) in the context of a violent storm that happened in the West-Romania on the 17th of September, 2017. h e casestudy with a 7-day retrospective investigation (15–21.09.2017) was performed on a sample of 43 patients (54,5% females and 45,5% males), admitted into the Neurology Section (I and II) with the following results obtaining regarding patients: 34,8% – admitted on 19.09.2017, 26–8% – 60-70 years; 34,9% – strokes, 24,5% – motor dei cit, 33,5% – TA = 140-160 mmHg, 33,5% – heart rate = 80-100 beats/minute. Average air temperature –21,20C, relative humidity – 66%, mean pressure – 735,5 mmHg and wind speed – 106,9 Km/h were recorded on the 17.09.2017. Only a weak association was found in relation stroke – gender (Fisher Test Exact = 0,043) and in relation heart rate – wind speed at gust (r=0,377, Sig. 0,033). In conclusion, there was no a statistically signii cant relationship between neurological conditions and meteorological factors. В проведенном исследовании мы стремились исследовать неврологические заболевания у пациентов, поступивших в неврологическое отделение (I и II) Окружной больницы г. Тимишоара, связанные с метеорологическими факторами (температура, влажность воздуха, скорость ветра и давление) в контексте сильной бури, которая произошла в Западной Румынии 17 сентября 2017 года. Исследование с 7-дневным ретроспективным анкетированием (15–21.09.2017) было проведено на выборке из 43 пациентов (54,5% женщин и 45,5% мужчин), поступивших в неврологическое отделение (I и II) с получением следующих результатов о пациентах: 34,8% поступили 19.09.2017, 26,8% – возраст 60-70 лет; 34,9% – с инсультом, 24,5% – с моторным дефицитом, 33,5% – артериальное давление = 140-160 мм рт.ст., 33,5% – сердечный ритм = 80-100 ударов в минуту. 17.09.2017 были зарегистрированы: средняя температура воздуха – 21-20ºС, относительная влажность – 66%, среднее давление – 735,5 мм рт.ст., скорость ветра – 106,9 км/ч. Только слабая связь была обнаружена в отношении пола и инсульта (Fisher Test Exact = 0,043) и в отношении частоты сердечных сокращений – скорости ветра при порыве (r=0,377, Sig. 0,033). В заключение, не было статистически значимой связи между неврологическими патологиями и метеорологическими факторами

Plasma hsa-mir-19b is a potential LevoDopa therapy marker

Parkinson's disease (PD) is the second most common neurodegenerative disorder among the elderly, the diagnostic and prognostic of which is based mostly on clinical signs. LevoDopa replacement is the gold standard therapy for PD, as it ameliorates the motor symptoms. However, it does not affect the progression of the disease and its long-term use triggers severe complications. There are no bona fide biomarkers for monitoring the patients' response to LevoDopa and predicting the efficacy of levodopa treatment. Here, we have combined qPCR microRNA array screening with analysis of validated miRs in naïve versus Levodopa-treated PD patients. We have identified plasma miR-19b as a possible biomarker for LevoDopa therapy and validated this result in human differentiated dopaminergic neurons exposed to LevoDopa. In silico analysis suggests that the LevoDopa-induced miR-19b regulates ubiquitin-mediated proteolysis

Outcomes Impacting Quality of Life in Advanced Parkinson's Disease Patients Treated with Levodopa-Carbidopa Intestinal Gel

BACKGROUND: It is believed that motor symptoms, including dyskinesia, and non-motor symptoms impact health-related quality of life (HRQoL) in patients with Parkinson’s disease (PD), and that improvements in these metrics are correlated. OBJECTIVE: Investigate the relationship between HRQoL and measures of PD severity and treatment efficacy, including motor and non-motor symptoms. METHODS: This was a planned investigation of an international, prospective, single-arm, post-marketing observational study of the long-term effectiveness of levodopa-carbidopa intestinal gel (LCIG) in patients with advanced PD. Pearson correlation coefficients (PCC) were calculated for baseline and change from baseline at 12 months between HRQoL and motor and non-motor symptoms. RESULTS: A total of 195 patients were included. At baseline, HRQoL was moderately positively correlated with Activities of Daily Living (UPDRS II, PCC = 0.44), non-motor symptoms (0.48), and measures of sleep (0.50 and 0.40); all p < 0.001. After 12 months of treatment with LCIG, improvements in HRQoL were moderately positively correlated with improvement from baseline in non-motor symptoms (PCC = 0.42), sleep (0.54), and daytime sleepiness (0.40; all p < 0.001), and weakly correlated with improvement in dyskinesia signs and symptoms (PCC = 0.23; p = 0.011). Improvement in HRQoL was not correlated with improvements in OFF time or dyskinesia time. CONCLUSION: Both at baseline and for change from baseline at 12 months, HRQoL was correlated with baseline and change from baseline in dyskinesia, Activities of Daily Living, and non-motor symptoms, including sleep; but not with baseline or change in OFF time

Advanced Parkinson&rsquo;s Disease Treatment Simplification and Long-Term Outcomes with Levodopa Carbidopa Intestinal Gel: COSMOS Romanian Subanalysis

The aim of the COmedication Study assessing Mono- and cOmbination therapy with levodopa-carbidopa inteStinal gel (COSMOS) was to assess the use of levodopa/carbidopa intestinal gel (LCIG) as monotherapy in patients with advanced Parkinson&rsquo;s disease (APD) in routine clinical practice. COSMOS was an international observational study with one cross-sectional visit and retrospective data collection. In Romania, 95 adult patients with APD on LCIG treatment for at least 12 months were enrolled and stratified according to their LCIG therapy after 12 months: monotherapy (without any add-on PD medication), monotherapy with night PD medication and LCIG + add-on medication. Compared to the moment of LCIG initiation, the percentage of patients on monotherapy increased at three months after LCIG initiation and remained constant up to 12 months, when 30.5% of the patients were on LCIG monotherapy and 11.6% were on monotherapy with night medication. &ldquo;Off&rdquo; time and &ldquo;On&rdquo; time with dyskinesia decreased from LCIG initiation to patient visit in all groups. LCIG monotherapy with or without night medication may provide a simplified treatment option for selected APD patients, with long-term efficacy similar to that of LCIG plus add-on medication

Parkinson’s Disease-Cognitive Rating Scale for Evaluating Cognitive Impairment in Parkinson’s Disease: A Systematic Review

The aim of the present systematic review was to examine the evidence on the accuracy and psychometric properties of the Parkinson’s Disease-Cognitive Rating Scale (PD-CRS) for evaluating the presence of cognitive impairment in patients with Parkinson’s disease (PD) as well as to highlight the quality and quantity of research available on the use of the PD-CRS in this population. We searched four databases from inception until July 2020. Eight studies, published between 2008 and 2020, met the inclusion criteria: One cross-sectional study in which participants were assessed with the index test (PD-CRS) and a reference standard diagnostic assessment, in accordance with the Level II criteria of the International Parkinson and Movement Disorder Society (MDS); one case-control study comparing the PD-CRS to an extensive battery of tests (i.e., MDS Level II diagnosis); and six studies comparing the PD-CRS to other short cognitive batteries. In patients with Parkinson’s disease, the PD-CRS test provides information about cortical and sub-cortical cognitive functions. Even if it demonstrated good psychometric properties, the results regarding the optimal threshold for detecting mild cognitive impairment and dementia in PD are somewhat inconsistent. Further cross-sectional studies are necessary to examine the optimum cut-off score for detecting cognitive dysfunction in PD patients

Border zone brain lesions due to neurotrichinosis

Trichinosis is a parasitic disease that, due to variable clinical syndromes, is often underrecognized. We present the case of a patient with eosinophilia, focal neurological signs and multiple bilateral brain lesions, distributed mainly in the border zones. The diagnostic workup revealed neurotrichinosis, which should be suspected even without a clear history of consumption of poorly cooked meat

Subarachnoid Hemorrhage in Patients with SARS-CoV-2 Infection: Protocol for A Scoping Review

Subarachnoid hemorrhage (SAH) is a life-threatening condition associated with high mortality and substantial long-term morbidity. The SARS-CoV-2 virus is a new pathogen that causes a disease with variable clinical manifestations. Although the Coronavirus disease 2019 (COVID-19) is associated with hypercoagulopathy, patients may also present with cerebral hemorrhage, including SAH. The present paper reports a protocol for a scoping review that is aimed to provide a comprehensive report on existing literature by examining data on SAH associated with SARS-CoV-2 infection. Our objective is to evaluate the epidemiology, clinical, laboratory, and neuroimaging features of SAH in patients with COVID-19 and to explore the etiology and possible interventions in this pathology. Using appropriate search terms, we will search LitCOVID, the WHO database on COVID-19, and MedRxiv. The inclusion criteria are pre-defined. We will extract the data of eligible studies in standardized forms and will report the results in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We will provide information for clinicians, healthcare providers, and public health specialists